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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.

Psychosocial influences on older adults' interest in participating in bowel cancer screening.

Background: Identification of a genetic basis underlying certain types of cancer has led to an increase in demand for genetic counseling about individual risks of the disease. We conducted a systematic review of the literature to determine the quality and strength of evidence relating to psychological outcomes of genetic counseling for familial cancer. Methods: Six electronic databases were searched to identify controlled trials and prospective studies that examined the effect of genetic counseling on risk perception, knowledge, anxiety, cancer-specific worry, depression, and cancer surveillance. Twenty-one studies from 25 papers met inclusion criteria, including five controlled trials and 16 prospective studies. Analysis of each outcome was stratified by short-term (≤1 month) and long-term (≥3 months) follow-up. Trial evidence was assessed with standardized differences of the means at follow-up between intervention and comparison groups, and these data were pooled by use of random-effects meta-analysis. Results: Meta-analysis of controlled trials showed that genetic counseling improved knowledge of cancer genetics (pooled short-term difference = 0.70 U, 95% confidence interval [CI] = 0.15 to 1.26 U) but did not alter the level of perceived risk (pooled short-term difference = -0.10 U, 95% CI = -0.23 to 0.04 U). Prospective studies reported improvements in the accuracy of perceived risk. No effect was observed in controlled trials on general anxiety (pooled long-term effect = 0.05 U, 95% CI = -0.21 to 0.31 U) or cancer-specific worry (pooled long-term difference = -0.14 U, 95% CI = -0.35 to 0.06 U), although several prospective studies demonstrated short-term reductions in these outcomes. Few studies examined cancer surveillance behaviors, and no studies attempted to measure informed choice. Conclusions: Genetic counseling for familial cancer is associated with improvement in knowledge but does not have an adverse effect on affective outcomes. We urge further investigation of these findings through well-designed, well-reported, randomized controlled trials with suitable comparison groups and additional outcome measures.

/pdf/psychological-impact-of-genetic-counseling-for-familial-3arr9fqr8n.pdf

Psychological impact of genetic counseling for familial cancer: a systematic review and meta-analysis

Aims Identifying patients’ beliefs about taking medication can inform interventions to support medication taking, and their evaluation. We set out to establish the range of these beliefs, and measure the frequency of commonly held beliefs and their correlation with intention to take medication and self-reported medication adherence. Methods An exploratory survey among Type 2 diabetic patients aged 40 years or older, registered in general practice, used a questionnaire measuring a range of plausible beliefs about taking and intention to take medication developed from interviews where belief elicitation was guided by the Theory of Planned Behaviour. The Medication Adherence Report Schedule was used as a self-report adherence measure. Results Questionnaires were returned by 121 (61.7%) people. The majority strongly agreed with statements about the benefits of taking medication. Negative beliefs that taking medication would ‘cause unpleasant side effects’ and ‘lead to weight gain’ were held by 24.1 and 13.9% of people, respectively. Beliefs about benefit were strongly associated with intention to take medication regularly. Two beliefs were associated with reduced medication adherence: ‘changes to my daily routine would make it more difficult to take my diabetes medicines regularly’ ( P < 0.001), and ‘if I were to take my diabetes medicines regularly this would lead to my gaining weight’ ( P < 0.05). Conclusions Use of a theoretical model to elicit and identify common beliefs about taking medication regularly underscores the importance of exploring weight-gain concerns and how to keep taking tablets when routines change. Beliefs associated with intention and taking medication will inform intervention development, implementation and evaluation in randomized controlled studies.

http://www.phpc.cam.ac.uk/pcu/files/2012/01/Farmeretal.pdf

Measuring beliefs about taking hypoglycaemic medication among people with Type 2 diabetes.

The vast majority of studies investigating stage theories of health behaviour such as the transtheoretical model have used a cross-sectional research design. Participants are classified into stages and compared on theoretically relevant variables. This paper discusses the proper interpretation of cross-sectional data on stages of change. Linear patterns are not consistent with the stage model assumption that different causal factors are important at different stages but discontinuity patterns (patterns that do not show consistent increments or decrements across stages) can be diagnostic of a stage model. Researchers who use cross-sectional designs should specify predictions concerning the patterns to be expected under a stage model and under possible rival models, and interpret their data accordingly. Wherever possible, they should conduct prospective longitudinal and experimental studies which enable stronger inferences to be drawn.

Interpreting cross-sectional data on stages of change

Based on the theories of reasoned action (TRA) and planned behavior (TPB), predictors of condom use intentions were investigated in 949 young people (16-24 years of age) from a national survey conducted in England. Contrary to expectations, the TPB did not perform significantly better than the TRA, even among women. Measures of past behavior were the best predictors of intentions and attenuated the effects of attitude and subjective norm. There was only weak evidence for the multiplicative assumption underlying the TRA and TPB. Although the TRA components were not the strongest predictors, the beliefs on which they are based are potentially amenable to change through information-based intervention programs. A number of practical suggestions for developing intervention strategies are offered.

A comparative test of the theory of reasoned action and the theory of planned behavior in the prediction of condom use intentions in a national sample of English young people.

Stephen Sutton

Papers

Psychosocial influences on older adults' interest in participating in bowel cancer screening.

Psychological impact of genetic counseling for familial cancer: a systematic review and meta-analysis

Measuring beliefs about taking hypoglycaemic medication among people with Type 2 diabetes.

Interpreting cross-sectional data on stages of change

A comparative test of the theory of reasoned action and the theory of planned behavior in the prediction of condom use intentions in a national sample of English young people.