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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.

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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)

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An attributional theory of achievement motivation and emotion.

Background-A multicentre randomised controlled trial to evaluate screening by "once only" flexible sigmoidoscopy (FS) for prevention of bowel cancer is in progress.Aims-To pilot the trial protocol examining rates of attendance, yield of neoplasia, and adverse effects. Subjects-A total of 3540 subjects aged 55-64 years in Welwyn Garden City (WGC) and 19 706 in Leicester (LE).Methods-Subjects responding positively to an "interest in screening" questionnaire were randomised to invitation for screening or control arms, Small polyps were removed during screening, Colonoscopy was undertaken for high risk polyps (more than two adenomas, size at least I cm, villous histology, severe dysplasia, or malignancy). The remainder were discharged.Results-In WGC and LE respectively, 59% and 61% indicated an interest in screening, of which 74% and 75% attended. Adenomas were detected in 10% and 9%, respectively, and cancers in 7 per 1000 (in both centres), 55% at Dukes's stage A. The colonoscopy referral rate was 6% in both centres, Mild, short lived bleeding occurred in 3%, One person died following surgery.Conclusions-Compliance rates, yield of adenomas, and referral rate for colonoscopy were as expected, but cancer detection rates were higher. Adverse effects following sigmoidoscopy or colonoscopy were mild and transient, but there was one postoperative death, A randomised trial is necessary to evaluate fully the risks and benefits of this intervention.

https://gut.bmj.com/content/gutjnl/42/4/560.full.pdf

Uptake, yield of neoplasia, and adverse effects of flexible sigmoidoscopy screening

BACKGROUND: A major cause of lapse and relapse to smoking during a quit attempt is craving triggered by cues from a smoker's immediate environment. To help smokers address these cue-induced cravings when attempting to quit, we have developed a context-aware smoking cessation app, Q Sense, which uses a smoking episode-reporting system combined with location sensing and geofencing to tailor support content and trigger support delivery in real time. OBJECTIVE: We sought to (1) assess smokers' compliance with reporting their smoking in real time and identify reasons for noncompliance, (2) assess the app's accuracy in identifying user-specific high-risk locations for smoking, (3) explore the feasibility and user perspective of geofence-triggered support, and (4) identify any technological issues or privacy concerns. METHODS: An explanatory sequential mixed-methods design was used, where data collected by the app informed semistructured interviews. Participants were smokers who owned an Android mobile phone and were willing to set a quit date within one month (N=15). App data included smoking reports with context information and geolocation, end-of-day (EoD) surveys of smoking beliefs and behavior, support message ratings, and app interaction data. Interviews were undertaken and analyzed thematically (N=13). Quantitative and qualitative data were analyzed separately and findings presented sequentially. RESULTS: Out of 15 participants, 3 (20%) discontinued use of the app prematurely. Pre-quit date, the mean number of smoking reports received was 37.8 (SD 21.2) per participant, or 2.0 (SD 2.2) per day per participant. EoD surveys indicated that participants underreported smoking on at least 56.2% of days. Geolocation was collected in 97.0% of smoking reports with a mean accuracy of 31.6 (SD 16.8) meters. A total of 5 out of 9 (56%) eligible participants received geofence-triggered support. Interaction data indicated that 50.0% (137/274) of geofence-triggered message notifications were tapped within 30 minutes of being generated, resulting in delivery of a support message, and 78.2% (158/202) of delivered messages were rated by participants. Qualitative findings identified multiple reasons for noncompliance in reporting smoking, most notably due to environmental constraints and forgetting. Participants verified the app's identification of their smoking locations, were largely positive about the value of geofence-triggered support, and had no privacy concerns about the data collected by the app. CONCLUSIONS: User-initiated self-report is feasible for training a cessation app about an individual's smoking behavior, although underreporting is likely. Geofencing was a reliable and accurate method of identifying smoking locations, and geofence-triggered support was regarded positively by participants.

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A Context-Sensing Mobile Phone App (Q Sense) for Smoking Cessation: A Mixed-Methods Study

Editors' Preface - Stephen Sutton, Andrew Baum and Marie Johnston Context and Perspectives in Health Psychology - Edward P Sarafino Epidemiology of Health and Illness - Reiner Rugulies, Birgit Aust and S Leonard Syme A Socio-Psycho-Physiological Perspective Biological Mechanisms of Health and Disease - Brent N Henderson and Andrew Baum Determinants of Health-Related Behaviours - Stephen Sutton Theoretical and Methodological Issues Health-Related Cognitions - Keith J Petrie and James W Pennebaker Individual differences, Health and Illness - Richard J Contrada and Tanya M Goyal The Role of Emotional Traits and Generalized Expectancies Stress, Health and Illness - Andrew Steptoe and Susan Ayers Living with Chronic Illness - Howard Leventhal et al A Contextualized, Self-Regulation Approach Lifespan, Gender and Cross-Cultural Perspectives in Health Psychology - Simon Murphy and Paul Bennett Communicating about Health Threats and Treatments - Theresa M Marteau and John Weinman Applications in Health Psychology - Stan Maes and Sandra N Boersma How Effective are Interventions? Research Methods in Health Psychology - David P French, Lucy Yardley and Stephen Sutton Assessment and Measurement in Health Psychology - Marie Johnston et al Professional Issues in Health Psychology - Cynthia D Belar and Teresa McIntyre

The SAGE Handbook of Health Psychology

This paper reports on a study carried out to identify predictors of uptake of cervical screening among 142 women (59% response rate) in inner London Two social cognition models were used: The Health Belief Model (HBM; Becker, 1974) and the Theory of Planned Behaviour (TPB; Ajzen, 1991) and in addition anticipated affect following non-attendance for screening was assessed The TPB emerged as by far the superior model for predicting screening intentions, explaining 51% of the variance in comparison with only 4% explained by the HBM variables However, neither model was able to predict a significant amount of variance in uptake of screening three months later Possible reasons for the poor prediction of this type of behaviour are discussed

http://umh1365.edu.umh.es/wp-content/uploads/sites/95/2013/02/Comparison-Models-TPB-HBM.pdf

Predicting uptake of a routine cervical smear test: A comparison of the health belief model and the theory of planned behaviour

Research has shown that cancer patients in general benefit from support group participation. However, few patients attend such groups. This study investigated differences between participants of a community cancer support group and a random selection of non-participants from the Cancer Registry. Data were collected through mail survey, and included variables identified through past research and variables derived from Leventhal's self-regulatory model of illness representations and the theory of planned behaviour. Sixty-three support group participants and 44 comparison sample respondents were recruited. Support group participants were more likely to be female, without a partner, younger, and to have more education and formal support than non-participants. They held more favourable views of support groups, believed that significant others were favourable towards participation, and perceived less difficulty in joining a group. They furthermore used more active, adaptive coping strategies and felt more control over their cancer, but were more distressed and anxious. Non-participants reported more support from a special person. A multivariate logistic regression analysis showed only psychosocial variables to be independent predictors of participation. As psychological variables are amenable to change, increase of appropriate support group participation should be possible, for instance by addressing patients' beliefs about support groups.

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Stephen Sutton

Papers

Uptake, yield of neoplasia, and adverse effects of flexible sigmoidoscopy screening

A Context-Sensing Mobile Phone App (Q Sense) for Smoking Cessation: A Mixed-Methods Study

The SAGE Handbook of Health Psychology

Predicting uptake of a routine cervical smear test: A comparison of the health belief model and the theory of planned behaviour

How do patients who participate in cancer support groups differ from those who do not