Showing papers in "Health Education Research in 2004"
TL;DR: It is argued that an understanding of the development of self-esteem, its outcomes, and its active protection and promotion are critical to the improvement of both mental and physical health.
Abstract: Self-evaluation is crucial to mental and social well-being. It influences aspirations, personal goals and interaction with others. This paper stresses the importance of self-esteem as a protective factor and a non-specific risk factor in physical and mental health. Evidence is presented illustrating that self-esteem can lead to better health and social behavior, and that poor self-esteem is associated with a broad range of mental disorders and social problems, both internalizing problems (e.g. depression, suicidal tendencies, eating disorders and anxiety) and externalizing problems (e.g. violence and substance abuse). We discuss the dynamics of self-esteem in these relations. It is argued that an understanding of the development of self-esteem, its outcomes, and its active protection and promotion are critical to the improvement of both mental and physical health. The consequences for theory development, program development and health education research are addressed. Focusing on self-esteem is considered a core element of mental health promotion and a fruitful basis for a broad-spectrum approach.
788 citations
TL;DR: This important resource offers an overview of the history, purpose, strengths, and limitations of process evaluation and includes illustrative case material of the current state of the art in process evaluation.
Abstract: Description: Process evaluation is an essential component of any program evaluation or intervention research effort. This important resource offers an overview of the history, purpose, strengths, and limitations of process evaluation and includes illustrative case material of the current state of the art in process evaluation. Process Evaluation for Public Health Interventions and Research fills an important gap in the literature for
653 citations
TL;DR: The results of this study show that bullying is still prevalent in Dutch schools and schools need to adopt a whole-school approach with their anti-bullying interventions.
Abstract: Bullying victimization is associated with several health issues. Prevention of bullying is therefore an important goal for health and education professionals. In the present study, 2766 children from 32 Dutch elementary schools participated by completing a questionnaire on bullying behavior, and the involvement of teachers, parents and classmates in bullying incidents. The results of this study show that bullying is still prevalent in Dutch schools. More than 16% of the children aged 9-11 years reported being bullied on a regular basis and 5.5% reported regular active bullying during the current school term. Almost half of the bullied children did not tell their teacher that they were being bullied. When teachers knew about the bullying, they often tried to stop it, but in many cases the bullying stayed the same or even got worse. With regard to active bullying, neither the majority of the teachers nor parents talked to the bullies about their behavior. Our results stress the importance of regular communication between children, parents, teachers and health care professionals with regard to bullying incidents. In addition, teachers need to learn effective ways to deal with bullying incidents. Schools need to adopt a whole-school approach with their anti-bullying interventions.
558 citations
TL;DR: A positive parental role model may be a better method for improving a child's diet than attempts at dietary control and provides some support for both the modelling and control theories of parental influence.
Abstract: The present study compared the modelling and control theories of parental influence on children’s eating attitudes and behaviour with a focus on snack foods. Matched questionnaires describing reported snack intake, eating motivations and body dissatisfaction were completed by 112 parent/child pairs. Parents completed additional items relating to control in terms of attempts to control their child’s food intake and using food as a tool for controlling behaviour. The results showed significant correlations between parent and child for reported snack intake, eating motivations and body dissatisfaction, indicating an important role for modelling. Parents were then divided according to their control scores. Children whose parents indicated greater attempts to control their child’s diets reported higher intakes of both healthy and unhealthy snack foods. In addition, those children whose parents indicated a greater use of food as a means to control their child’s behaviour reported higher levels of body dissatisfaction. The results provide some support for both the modelling and control theories of parental influence. However, whereas modelling appears to have a consistent impact, parental control has a differential impact depending upon whether this control is focused on the child’s diet or on other aspects of their behaviour. To conclude, a positive parental role model may be a better method for improving a child’s diet than attempts at dietary control.
528 citations
TL;DR: This paper argues the case for the use of Q methodology when studying attitudes and justifies why Q methodology should particularly be selected in the study of attitudes within the health field.
Abstract: Attitudes are often referred to, researched and considered in the discipline of health education and health promotion. This paper highlights Q methodology as an appropriate and relevant means of exploring and studying attitudes within this field. It begins by discussing the difficulties in defining attitude and the problems inherent in attitude measurement. A brief history of Q methodology is given, followed by an explanation of what Q methodology is and the processes involved. This paper argues the case for the use of Q methodology when studying attitudes and justifies why Q methodology should particularly be selected in the study of attitudes within the health field. There are many reasons for this assertion which are explored throughout the paper. The principle one is that Q methodology is a more robust technique, than alternative methods, for the measurement of attitudes and subjective opinion. This paper concludes by proposing that Q methodology is taken up by researchers within health education and health promotion who are concerned with exploring attitudes and subjective opinion.
459 citations
TL;DR: Physical education may make a more significant contribution to young people's regular physical activity participation if lessons are planned and delivered with moderate-and-vigorous and vigorous intensity physical activity goals in mind.
Abstract: The purpose of this study was to assess physical activity levels during high school physical education lessons. The data were considered in relation to recommended levels of physical activity to ascertain whether or not physical education can be effective in helping young people meet health-related goals. Sixty-two boys and 60 girls (aged 11–14 years) wore heart rate telemeters during physical education lessons. Percentages of lesson time spent in moderate-and-vigorous (MVPA) and vigorous intensity physical activity (VPA) were recorded for each student. Students engaged in MVPA and VPA for 34.3 6 21.8 and 8.3 6 11.1% of lesson time, respectively. This equated to 17.5 6 12.9 (MVPA) and 3.9 6 5.3 (VPA) min. Boys participated in MVPA for 39.4 6 19.1% of lesson time compared to the girls (29.1 6 23.4%; P < 0.01). High-ability students were more active than the average- and low-ability students. Students participated in most MVPA during team games (43.2 6 19.5%; P < 0.01), while the least MVPA was observed during movement activities (22.2 6 20.0%). Physical education may make a more significant contribution to young people’s regular physical activity participation if lessons are planned and delivered with MVPA goals in mind.
285 citations
TL;DR: A hierarchical multiple regression analysis provided strong support for the role of self-efficacy as a major determinant of intention in the context of blood donation as defined within the Theory of Planned Behaviour.
Abstract: Given that self-efficacy has emerged as a key construct in health psychology, this study set out to explore its utility in the context of blood donation as defined within the Theory of Planned Behaviour (TPB). An Ajzen and Fishbein-type questionnaire was administered to 100 undergraduate students at the University of Ulster, Coleraine. A hierarchical multiple regression analysis provided strong support for the role of self-efficacy as a major determinant of intention. It not only helped to explain some 73% of the variance, but also made a greater contribution to the prediction of intention than the other main independent variables of the model-past behaviour and self-identity. Demonstrating the utility of self-efficacy in the context of blood donor behaviour not only has several important practical implications, but serves to further highlight its importance within the TPB.
278 citations
TL;DR: The methodological case for narrative inquiry is made as a unique means to get inside the world of health promotion practice and how this form of inquiry may reveal what practitioners value most in and through their practice, and the indigenous theory or the cause-and-consequence thinking that governs their actions.
Abstract: Research interest in the analysis of stories has increased as researchers in many disciplines endeavor to see the world through the eyes of others. We make the methodological case for narrative inquiry as a unique means to get inside the world of health promotion practice. We demonstrate how this form of inquiry may reveal what practitioners value most in and through their practice, and the indigenous theory or the cause-and-consequence thinking that governs their actions. Our examples draw on a unique data set, i.e. 2 two years' of diaries being kept by community development officers in eight communities engaged in a primary care and community development intervention to reduce postnatal depression and promote the physical health of recent mothers. Narrative inquiry examines the way a story is told by considering the positioning of the actor/storyteller, the endpoints, the supporting cast, the sequencing and the tension created by the revelation of some events, in preference to others. Narrative methods may provide special insights into the complexity of community intervention implementation over and above more familiar research methods.
276 citations
TL;DR: Stage-based activity promotion interventions that have been developed to date may have failed to appreciate the true complexity of the task and may simplify exercise behaviour beyond what is useful for practitioners and health promoters.
Abstract: Despite the well-described benefits of regular physical activity, around 70% of adults in the UK fail to meet current activity recommendations. Interventions based on the Transtheoretical, or Stages of Change, Model of behaviour change have been proposed as one potentially effective method of promoting physical activity levels. However, two recent reviews have found little evidence that individualized stage-based activity promotion interventions are any more effective than control conditions in promoting long-term adherence to increased levels of physical activity. Possible reasons for this are: that exercise behaviour is a more complex group of behaviours than currently recognized; that many algorithms for determining current stage of activity change have not been validated; that exercise behaviour is determined by a number of factors not addressed by stagebased interventions; that the stages of change model encourages focus on stage progression which is not always associated with behaviour change; and that truly stage-based interventions are highly complex requiring more than one level of development and evaluation— a challenge that has not yet been met. Thus, stage-based activity promotion interventions may simplify exercise behaviour beyond what is useful for practitioners and health promoters. Paradoxically, stage-based activity promotion interventions that have been developed to date may have failed to appreciate the true complexity of the task.
268 citations
TL;DR: The findings of this study contribute to a broader understanding of children's perceptions of their environment, and highlight the potential importance of the home and neighborhood environments for promoting physical activity behavior.
Abstract: Environmental factors may have an important influence on children’s physical activity, yet children’s perspectives of their home and neighborhood environments have not been widely assessed. The aim of this study was to investigate children’s perceptions of their environments, and to examine associations between these perceptions and objectively measured physical activity. The sample consisted of 147, 10-year-old Australian children, who drew maps of their home and neighborhood environments. A subsample of children photographed places and things in these environments that were important to them. The maps were analyzed for themes, and for the frequency with which particular objects and locations appeared. Physical activity was objectively measured using accelerometers. Six themes emerged from the qualitative analysis of the maps and photographs: the family home; opportunities for physical activity andsedentarypursuits;fooditemsandlocations; green space and outside areas; the school and opportunities for social interaction. Of the 11 variables established from these themes, one home and two neighborhood factors were associated with children’s physical activity. These findings contribute to a broader understanding of children’s perceptions of their environment, and highlight the potential importance of the home and neighborhood environments for promoting physical activity behavior.
263 citations
TL;DR: An examination of potentially unhelpful or dangerous outcomes of child obesity prevention efforts is required before prevention activities begin, and one of the most important principles of modern medicine and prevention science is employed, ‘First, do no harm’.
Abstract: The prevalence of child obesity has steadily increased in Western and developing countries over the last two decades, and child obesity prevention is now firmly on the agendas of nearly all major governments. We are now confronted with the challenge of what to do about the problem, and the general consensus among various academics, researchers, practitioners and administrators worldwide is that prevention needs to begin. Before governments and other agencies leap into actions that they assume to be beneficial in the battle against child obesity, we must remember to employ one of the most important principles of modern medicine and prevention science, ‘First, do no harm’. An examination of potentially unhelpful or dangerous outcomes of child obesity prevention efforts is required before prevention activities begin. There are many examples of perfectly reasonable and wellintentioned health messages being partially misconstrued or misunderstood by members of the general public, resulting in the inadvertent production of undesirable effects in the implementation of supposedly health-promoting activities. The uptake of dieting and slimming among girls and young women is one example of a health message gone wrong. The moderate and sensible government dietary guideline of the late 1970s was taken up by the target audience who required it least—young women, who adhered to the ‘control your weight’ message most vehemently. The exponential rise in disordered eating that followed these early messages has left health educators with the huge challenge of normalizing body image and eating behavior among a large proportion of our young population. The government message to control weight within reasonable limits was clearly exploited by cigarette advertisers who utilized the belief that cigarette smoking could be an effective slimming agent. This is an example of a health-related message going astray. What we failed to achieve as health educators, was to clarify this situation, that yes, controlling your weight is important, but not at the expense of other health behaviors. Multi-national corporations and marketers of the 1950s to 1980s clearly delivered the ‘smoking is slimming message’ and this well entrenched way of thinking has placed current health educators in the uneasy predicament of having to encourage quitters to believe that the benefits of quitting despite the expected risk of weight gain outweigh the perceived benefits of slimness. A huge challenge indeed! Similarly, the early ‘control your weight’ messages of the past, and those of today, clearly identify people who were overweight as failures, deviants or moral outcasts who needed some sort of ‘treatment’, most of which, when undertaken by the overweight person, resulted in further failure, defeat and humiliation, leaving us with the current prevalence of obesity of today. Is our message to overweight people and obese children any different today? Are our current preventive strategies any different or any more likely to succeed? To whom is University of Sydney, Faculty of Education, Building A35, Sydney, NSW 2006, Australia Correspondence to: J. A. O’Dea; E-mail: j.o’dea@edfac.usyd.edu.au HEALTH EDUCATION RESEARCH Vol.20 no.2 2005 Theory & Practice Pages 259–265 Advance Access publication 24 August 2004
TL;DR: Overall, empirical support was found for the decision to use TPB as the theoretical underpinning of the advertising, and the advertising was effective in triggering desired communications outcomes, and was associated with significant changes in attitudes and affective beliefs about speeding.
Abstract: The Theory of Planned Behaviour (TPB) has been widely applied to the explanation of health and social behaviours. However, despite its potential to inform behaviour change efforts, there have been surprisingly few attempts to use the TPB to design actual interventions. In 1998, the Scottish Road Safety Campaign implemented a 3-year mass media campaign to reduce speeding on Scotland's roads which was explicitly shaped by the TPB's three main predictors: Attitude, Subjective Norms and Perceived Behavioural Control. A 4-year longitudinal cohort study examined the impact of the campaign on communications outcomes and on TPB constructs. Overall, empirical support was found for the decision to use TPB as the theoretical underpinning of the advertising. The advertising was effective in triggering desired communications outcomes, and was associated with significant changes in attitudes and affective beliefs about speeding. In conclusion, future directions for road safety advertising and for TPB research are discussed.
TL;DR: The Transtheoretical model (TTM) has for some time now enjoyed fame (or even notoriety) in health education research and has been published in a number of articles over recent years.
Abstract: The Transtheoretical Model (TTM) has for some time now enjoyed fame (or even notoriety). Indeed, Health Education Research has been pleased to publish a number of articles over recent years. We were especially pleased to publish Adams and White’s (Adams and White, 2004) interesting and arguably heretical paper which appears in this edition of the Journal (and was published in advance on our website). We felt this would be an excellent opportunity to repeat our recent venture in which we invited a Commentary Group of distinguished researchers to react to three articles on the European Smoking Prevention Framework Approach in Health Education Research, 18(6), 664–677 (2003). Accordingly, we invited six equally distinguished commentators to provide a critical review of the TTM. We are very grateful to these six colleagues for their efforts—and, of course, we thank Jean Adams and Martin White for not only agreeing to their paper being subjected to critical scrutiny, but actively encouraging debate on a subject that is partly technical and partly ideological! Keith Tones Executive Editor
TL;DR: Valid and reliable tools that can be applied across multiple coalitions are necessary in order to achieve a better understanding of the associations among factors influencing optimal coalition functioning and community health impacts and outcomes.
Abstract: Community coalitions and partnerships are frequently used to promote community health; however, little research to evaluate measurement tools for assessing their effectiveness has been reported. This summary identified measurement tools for coalition or partnership characteristics and functioning. The largest numbers of measures were identified for assessing individual and group characteristics, with impact and outcome measures being the least numerous. Published measures often lacked information regarding validity and reliability, with internal consistency reliability being the most commonly reported statistic. Some measures were well defined, but others lacked conceptual clarity. Valid and reliable tools that can be applied across multiple coalitions are necessary in order to achieve a better understanding of the associations among factors influencing optimal coalition functioning and community health impacts and outcomes.
TL;DR: Results of this study suggest that intervention programmes to promote physical activity need to consider seasonal and geographical location differences in physical activity levels.
Abstract: This study attempted to examine differences in physical activity levels between urban and rural primary school children. The sample consisted of 256 Greek-Cypriot children and their parents from two schools representing urban areas and three schools representing rural areas. Children's activity levels were assessed for 4 weekdays in the winter and for 4 weekdays in the summer using a pedometer (DW-200; Yamax, Tokyo, Japan). Daily step counts were used to describe children's activity levels. Parents completed a questionnaire assessing environmental variables in both seasons. Two-way ANOVAs indicated that urban school children were significantly more active in winter than rural school children (means = 13,583 +/- 4,313 versus 12 436 +/- 3610, P < 0.001) and that rural school children were significantly more active in the summer (means = 16,450 +/- 5134 versus 14,531 +/- 4,901, P < 0.001). Parents of children in rural schools reported more space available in the garden and in the neighbourhoods, and safer neighbourhoods than parents of children in urban schools, whereas children in urban schools had more exercise equipment available at home and were transported more frequently to places where they could be physically active. Results of this study suggest that intervention programmes to promote physical activity need to consider seasonal and geographical location differences in physical activity levels.
TL;DR: It is possible that general schemes such as DISCERN will provide users with simple and flexible skills for dealing with the wide range of treatment information available, and may help users discriminate between high- and low-quality online treatment information.
Abstract: This study examined the application of DISCERN—validated criteria for judging the quality of printed information on treatment—to online health information in a workshop setting. A survey was conducted amongst 57 participants attending DISCERN Online workshops. Participants were health information users—health care and information providers, consumers (patients/carers), and consumer representatives. Workshops involved using DISCERN to appraise a health website. Participants completed questionnaires before and after the workshop, and at 2 months followup. Responses revealed that participants accessed online health information for professional (85.7%) and personal (75%) reasons. Less than half (41%) had applied some form of quality criteria to online information prior to attending the workshop. Despite varying levels of expertise, participants found DISCERN and the supporting materials accessible. The majority (96.2%) agreed DISCERN would help users discriminate between high- and lowquality online treatment information, and would be applicable to a wide variety of such information. At follow-up, most (89.6%) reported that their attitude to consumer health information of all types had changed—mostly becoming more critical or systematic. It is possible that general schemes such as DISCERN will provide users with simple and flexible skills for dealing with the wide range of treatment information available.
TL;DR: Results suggest this type of theory-based program is effective in modifying psychosocial variables related to postponing sexual intercourse and related to condom use among adolescents.
Abstract: The effectiveness of an intervention based upon the theories of Ajzen and Triandis was evaluated among 698 junior and 306 senior high school students. The intervention to juniors was offered by senior students who were trained during a course integrated into the school curriculum. Respondents in the control and experimental groups completed a questionnaire at baseline and 9 months after the program. Compared to junior respondents in the control group, those in the experimental group positively modified their attitude, perceived behavioral control, personal normative beliefs, perceived role beliefs, anticipated regret and intention with respect to postponing sexual intercourse and with respect to condom use, as well as perceived self-efficacy to negotiate both behaviors. Compared to senior respondents in the control group, those in the experimental group showed a significant positive modification of all the above variables except perceived behavioral control (indirect measure), anticipated regret and intention with respect to postponing sexual intercourse. At post-test, seniors in the experimental group were more likely to use condoms on a regular basis than those in the control group. Program effects occurred among both sexes, but a few differences in response were observed among males and females. Results suggest this type of theorybased program is effective in modifying psychosocial variables related to postponing sexual intercourse and related to condom use among adolescents. Personal involvement in designing intervention appears to be effective in modifying the behavior of peer educators.
TL;DR: A three-round Delphi study among stages of change researchers was conducted to make an inventory of opinions and examine agreement on determinants of forward transitions between Transtheoretical stages ofChange to identify hypotheses worthy of further examination in longitudinal observational and experimental studies.
Abstract: Insight into stage transition determinants is necessary to develop and evaluate stage-tailored health-promoting interventions. A three-round Delphi study among stages of change researchers was conducted to make an inventory of opinions and examine agreement on determinants of forward transitions between Transtheoretical stages of change. In the first round, 10 experts completed an electronic questionnaire with open-ended questions about potential determinants for each stage transition. In the second round, a structured electronic questionnaire based on the first round results was sent to authors of scientific papers on stages of change, published between 1995 and May 2002. In the third round, participants were presented feedback about the second round and were asked to re-rate their answers based on the information provided. Results showed that participants agreed on various transition determinants, but that determinants were not always stage-specific, e.g. control-related issues and social support were identified as determinants of all transitions from contemplation to maintenance. The results further showed lower consensus about determinants of earlier stage transitions than about determinants of later stage transitions. The Delphi study identified hypotheses worthy of further examination in longitudinal observational and experimental studies.
TL;DR: It was concluded that low-back pain is a common complaint during childhood, although most cases are acute episodes that represent little health consequence and in contrast, some children experience recurrent low- back pain that can lead to disabling consequences.
Abstract: The aim of this investigation was to provide evidence of the prevalence and consequences of recurrent low-back pain in children from Northwest England. A cross-sectional survey was conducted involving a standardized questionnaire with established reliability and validity. A cross-sectional sample of 500 boys (n = 249) and girls (n = 251) aged between 10 and 16 years participated in the study. Average lifetime prevalence of low-back pain was 40.2% [95% confidence interval (CI) = 38.7‐41.6]. Most cases of low-back pain were acute episodes that did not lead to disabling consequences. In contrast, 13.1% (95% CI = 12.5‐ 13.7) experienced recurrent low-back pain that led to disabling consequences; 23.1% visited a medical practitioner, 30.8% experienced loss of physical activity/sports and 26.2% had been absent from school because of low-back pain. Recurrent low-back pain was particularly evident during late adolescence where one in five children were cases. The health education implications of low-back pain in children are discussed. It was concluded that low-back pain is a common complaint during childhood, although most cases are acute episodes that represent little health consequence. In contrast, some children experience recurrent low-back pain that can lead to disabling consequences. Future research should focus on recurrent lowback pain cases since they often led to disabling consequences.
TL;DR: Evidence is provided that parental expectations may protect early adolescents against smoking even in the context of increases in favorable attitudes and friends who smoking, as well as the effect on smoking initiation of attitudes toward deviance or the number of friends who smoke.
Abstract: Substantial research and theory suggests that smokinginitiationissociallymediated,withboth peers and parents playing important roles. To learn more about how parenting behaviors influence smoking initiation, students (n 51002) from four middle schools were surveyed at the beginning of the sixth grade (T1), and the end of the sixth (T2) and seventh (T3) grades. T1 and T2 2 T1 predictors were regressed on smoking initiation at the end of seventh grade. In bivariate logistic regression analyses, association with friends who smoke, attitudes toward deviance, outcome expectations for smoking, perceived school climate, parental expectations, parental involvement at T1 and increases in these variables (T2 2 T1) were associated with smoking initiation at T3, but only the T1 measures of social competence, academic engagement, school adjustment, perceived prevalence, parental monitoring and parental involvement were associated with smoking initiation at T3. In multivariate logistic regression analyses, parental expectations were negatively associated, and increases in attitudes accepting of deviance and affiliation with friends who smoke were positively associated with smoking initiation. Analysis of interactions indicated that parental expectations and monitoring did not mediate the effect on smoking initiation of attitudes toward deviance or the number of friends who smoke. These findings provide evidence that parental expectations may protect early adolescents against smoking even in the context of increases in favorable attitudes and friends who smoking.
TL;DR: While all but three of the interview respondents described experiencing at least one barrier to eating more fruit and vegetables, three quarters reported an increase in intake of between one and five daily portions, suggesting that health behaviour interventions that are negotiated and non-prescriptive may be more successful than those that are relatively inflexible.
Abstract: This qualitative study compares the barriers to eating more fruit and vegetables reported before and after participation in a 6-month randomized controlled trial in primary care. At the initial intervention appointment of a primary care intervention to promote eating five or more portions of fruit and vegetables a day, participants were asked to identify the barriers that they thought they might encounter. Barriers were discussed again at the final appointment 6 months later. At the end of the study, a purposive sample of 40 of the trial participants was interviewed to explore their experiences in greater detail. Transcripts of tape recordings of the intervention appointments and the semi-structured interview were analysed using qualitative methods. This paper presents the results of a qualitative analysis of these appointment and interview transcripts (results of the trial are published elsewhere). Women reported that children and male partners were obstructive to their attempts to eat more fruit and vegetables, whilst men reported that their partners were supportive of the change. The perception that fruit and vegetables were expensive was a relatively intractable barrier for those with inflexible food budgets. Some barriers, including the problem of getting fruit and vegetables when travelling or when the daily routine is disrupted such as at weekends, were not anticipated and only encountered when participants tried to make changes. However, while all but three of the interview respondents described experiencing at least one barrier to eating more fruit and vegetables, three quarters (29 of 40) reported an increase in intake of between one and five daily portions. This study adds to the existing literature in that it investigates those barriers that were reported at the end of, as well as before, a 6-month trial of a dietary intervention. The findings show that trial participants were not always able to anticipate what might be a barrier to change at the initial intervention appointment. The flexible action plan meant that if participants found their initial plan hard to maintain, they were able to adapt it rather than give up. This suggests that health behaviour interventions that are negotiated and non-prescriptive may be more successful than those that are relatively inflexible.
TL;DR: An interactive multimedia program to encourage individuals to decrease their dietary fat consumption and to increase consumption of fruits and vegetables was developed and evaluated at two worksites and demonstrated the potential for short-exposure interactive programs to positively impact eating habits of employee populations.
Abstract: An interactive multimedia program to encourage individuals to decrease their dietary fat consumption and to increase consumption of fruits and vegetables was developed and evaluated at two worksites. The program presented content tailored to the user by gender, content interests, race, and age group. It was tested using a randomized treatment and wait list control design (n = 517). Repeated-measures ANOVAs indicated significant intervention effects after 30 days for self-reported consumption of fat and of fruits and vegetables, for stage of change to adopt a low-fat diet, for intention and self-efficacy to reduce dietary fat, and for attitude toward the importance of diet. In addition, 60-day follow-up of the treatment subjects found that program effects were maintained on all measures. Within- subject analyses showed that program effects were replicated with the wait list group at 30 days. These results demonstrate the potential for short-exposure interactive programs to positively impact eating habits of employee populations.
TL;DR: The relationship between acculturation and smoking behavior was examined in four Asian-American groups that included recent immigrants and US-born Koreans, Chinese, Vietnamese and Cambodians residing in the Delaware Valley of Pennsylvania and New Jersey to assess a broad array of knowledge, attitudes and behaviors on tobacco use and tobacco-related cancer issues.
Abstract: The relationship between acculturation and smoking behavior was examined in four Asian-American groups that included recent immigrants and US-born Koreans, Chinese, Vietnamese and Cambodians residing in the Delaware Valley of Pennsylvania and New Jersey. The study was part of a community-based, comprehensive cross-sectional study designed to assess a broad array of knowledge, attitudes and behaviors on tobacco use and tobacco-related cancer issues in the target multi-ethnic and multi-lingual Asian-American community. The sample of 1374 respondents was selected using a stratified-cluster proportional sampling technique, with a response rate of 83%. Findings indicated that acculturation had a variable effect on smoking behavior: more acculturated youth and less acculturated male adults had higher smoking rates than the less acculturated youth and the more acculturated male adults. Smoking rates for all females were generally lower than those of males regardless of acculturation status; however, acculturated adult females had a higher smoking rate than the less acculturated.
TL;DR: Comparing the effectiveness of a printed message about polio vaccinations with the same message converted into a production of animated cartoons using marketing and advertising techniques showed that a well-designed animated cartoon is more effective in delivering a message than the same information provided in written instructional materials.
Abstract: Communication is a major problem in the management of patients. Miscommunication occurs frequently in populations with low reading skills, illiteracy does not completely account for the observed low rates of recall of communicated information. Transmission of the message also plays an important role. Successful strategies to improve communication with patients include the use of videotapes, videotape modeling or cartoon illustrations. Do these products communicate effectively because they overcome illiteracy or because they also transmit a very clear message? Can good transmission of messages overcome illiteracy? In this study, we compared the effectiveness of a printed message about polio vaccinations with the same message converted into a production of animated cartoons using marketing and advertising techniques. The production that resulted from using this strategy showed that in the setting of this study, a well-designed animated cartoon is more effective in delivering a message than the same information provided in written instructional materials.
TL;DR: The results demonstrate that aspects of anti-smoking socialization, such as parental monitoring, norms on adolescents smoking and reactions on adolescent smoking, are related to smoking-related cognitions,such as negative attitudes to smoking, lower intentions to start smoking and higher self-efficacy.
Abstract: Parents play an important role in the development of young people’s smoking behavior, through the modeling effects of their own smoking status, through the ways they raise their children and through the ways they deal with smoking at home. The present study focused on anti-smoking socialization by, first, comparing the perspectives of both parents and an adolescent on eight indicators of anti-smoking socialization. In addition, we aimed to examine how these indicators of anti-smoking socialization are related to adolescent smokingrelated cognitions (e.g. attitudes, self-efficacy, intentions to smoke). Data were collected from 116 Dutch families with fathers, mothers and adolescents (10‐19 years old) included. Selfreports of these family members were used by means of questionnaires that were sent through the Internet. The findings showed that parents and adolescents differ in their reports on antismoking socialization. In general, mothers are more positive about anti-smoking socialization than adolescents and fathers. Furthermore, the results demonstrate that aspects of anti-smoking socialization, such as parental monitoring, norms on adolescents smoking and reactions on adolescent smoking, are related to smokingrelated cognitions, such as negative attitudes to smoking, lower intentions to start smoking and higher self-efficacy. These findings are a first step in research on smoking-specific socialization that is considered to be of importance for the development of effective smoking prevention programmes focusing on parents. Nonetheless, longitudinal studies on large samples of families are needed to replicate the findings in this study.
TL;DR: Compared with theoretical predictions, precontemplators had higher rates of endorsement of specific barriers to screening and lower rates of endorsements of benefits than contemplators or actors, which can guide development of screening-promoting interventions.
Abstract: In 2003, over 148 300 people were expected to be diagnosed and 56 000 to die from colorectal cancer (CRC). First-degree relatives (FDRs) of people with colon cancer have a two- to eightfold increased risk for CRC. Despite evidence that screening is effective, adherence with screening recommendations in this at-risk population is low. This study’s purposes were to (1) identify perceived benefits and barriers of fecal occult blood testing (FOBT), sigmoidoscopy and colonoscopy, and (2) compare demographic characteristics and perceived benefits and barriers by stage of adoption for CRC screening. Participating FDRs (n 5 257) completed a 40-min structured telephone interview. Despite high rates of agreement with the benefits of screening, most FDRs were not contemplating being screened. Of those 50 and older, most were in precontemplation for FOBT, sigmoidoscopy and colonoscopy. Older age was related to stage for FOBT and sigmoidoscopy, but not colonoscopy. Lack of provider recommendation also was related to stage. Consistent with theoretical predictions, precontemplators had (1) higher rates of endorsement of specific barriers to screening and (2) lower rates of endorsement of benefits than contemplators or actors. For morbidity and mortality reduction, participation in routine, periodic screening is imperative. These findings can guide development of screening-promoting interventions.
TL;DR: This newly developed pictographic scale may be useful in assessing medication adherence self-efficacy in lower-literacy populations and support its convergent, divergent and criterion-related validity, including associations with medication adherence and HIV viral load.
Abstract: Health behavior interventions are often groundedin Social Cognitive Theory,butinstruments used to assess self-efficacy rely on verbal skills and yield scores that are highly positively skewed. Based on a review of the research literature and qualitative research with key informants, a pictographic medication adherence self-efficacy scale was developed. Two studies were conducted to test the pictographic and color visual analogue scale for assessing self-efficacy for medication adherence. Study 1 (N 5 81) demonstrated that the pictographic self-efficacy scale was internally consistent (a 5 0.68), time stable (2-week test‐re-test r 5 0.63), and showed evidence for convergent and divergent construct validity. Study 2 (N 5 64) further supported the reliability of the pictographic self-efficacy scale with additional data supporting its convergent, divergent and criterion-related validity, including associations with medication adherence and HIV viral load. Distributions of self-efficacy scores approximated normal. This newly developed pictographic scale may be useful in assessing medication adherence self-efficacy in lowerliteracy populations.
TL;DR: This paper provides a description of and rationale for components of a theoretically based conceptual model that guided the development and implementation of the Fathers and Sons Intervention Program, designed to prevent risky health behaviors among non-resident African-American fathers and their pre-adolescent sons.
Abstract: This paper provides a description of and rationale for components of a theoretically based conceptual model that guided the development and implementation of the Fathers and Sons Intervention Program. Using a community-based participatory research process, this intervention was designed to prevent risky health behaviors through strengthening father– son relationships among non-resident AfricanAmerican fathers and their pre-adolescent sons. The implications of the conceptual model for future interventions with African-American fathers and sons are discussed.
TL;DR: The findings indicate that the intervention had a positive impact on participants, and given the increasing rate of HIV/AIDS in Belize, this study has important implications for the country of Belize.
Abstract: The purpose of this study was to evaluate the impact of a cognitive-behavioral peer-facilitated school-based HIV/AIDS education program on knowledge, attitudes and behavior among primary and secondary students in Belize. Students (N = 150) were recruited from six schools in Belize City. A quasi-experimental research design was used to assess the impact of a 3-month intervention. Seventy-five students received the intervention and 75 students served as controls. The intervention was guided by constructs from the Theory of Reasoned Action and Social Cognitive Theory. At the follow-up assessment, the intervention group showed higher HIV knowledge, were more likely to report condom use, had more positive attitudes toward condoms and were more likely to report future intentions to use condoms than the students in the control group. Overall, the findings indicate that the intervention had a positive impact on participants. Given the increasing rate of HIV/AIDS in Belize, especially among adolescents, this study has important implications for the country of Belize.
TL;DR: The issue of student participation from the perspective of the health-promoting schools initiative is addressed and the model distinguishing between two different qualities of participation-genuine and token participation-are presented and discussed in the paper.
Abstract: The paper addresses the issue of student participation from the perspective of the healthpromoting schools initiative. It draws on experience from the Macedonian Network of Health-Promoting Schools and its collaboration with the Danish as well as other country networks within the European Network of HealthPromoting Schools. Student participation is viewed as one of the main focal points of the conceptual framework and model of a healthpromoting school developed within the Macedonian context. This model and the model distinguishing between two different qualities of participation—genuine and token participation—are presented and discussed in the paper. Underpinning values that these models endorse as important for the processes of health promotion in schools include self-determination, participation, democracy, diversity and equity.