ISSN:1359-107X    

DOI:10.1111/bjhp.12038

年代:2013

数据来源: WILEY

摘要:

ObjectivesTo examine the variability of illness and treatment perceptions – that have been found to be associated with chronic kidney disease (CKD) patients' outcomes (e.g., quality of life) – across theCKDtrajectory, by investigating whether there are differences in perceptions in patients: (1) on varying treatments (pre‐dialysis, haemodialysis, peritoneal dialysis), (2) with varying lengths of time on (dialysis) treatment, and (3) over time on dialysis, with an 8‐month interval.Design and methodsMixed cross‐sectional and longitudinal design, using self‐report questionnaires on illness and treatment perceptions; the study sample consisted of 105 pre‐dialysis and 161 dialysis patients; of the 161 dialysis patients, 87 patients filled in the questionnaires again after an 8‐month interval. Data were examined using multilevel (multivariate) repeated measurements regression analyses, controlled for background characteristics and repeated measures.ResultsPatients on haemodialysis and peritoneal dialysis believed more strongly that theirtreatment controlstheir illness (p < .05,p < .01, respectively) and perceived moreillness consequences(p < .001,p < .05, respectively) than pre‐dialysis patients. Haemodialysis patients perceived moretreatment consequencesthan pre‐dialysis (p < .001) and peritoneal dialysis patients (p < .01). The perception ofillness understandingfluctuated between patients with varying lengths of time on dialysis (p < .05). Perceivedtreatment consequenceswere more negative in patients who were on dialysis for longer lengths of time (p < .01). Lastly, perceptions of illness and treatment varied within dialysis patients over an 8‐month interval, withtreatment controlandpersonal controlshowing the lowest correlations.ConclusionsFindings suggest that illness and treatment perceptions vary across theCKDtrajectory. This indicates that perceptions are amenable to influences and that interventions might potentially be helpful in influencing them in order to improve outcomes.Statement of ContributionWhat is already known on this subject?Dialysis patients' perceptions of illness understanding and illness symptoms vary over the first year on dialysis.Established haemodialysis patients' perceptions of illness understanding, emotional response and treatment control vary over a 2‐year period.Certain illness perceptions as well as treatment perceptions vary as a function of treatment type in patients withCKDstage 5 (dialysis patients, patients with a kidney transplant).What does this study add?Patients' perceptions of illness understanding andtreatment consequencesvary between patients as a function of length of time on (haemo‐, peritoneal‐) dialysis, taking into account a wide range of time (0–10 years).Illness perceptions and treatment perceptions of patients on haemodialysis andperitoneal dialysisvary within patients over an 8‐month interval, with perceptions of treatment control and personal control showing the highest variations.Perceptions of illness consequences, treatment consequences and treatment control vary as a function of type of treatment, taking into accountpre‐dialysis treatment(CKDstage 4) and dialysis (haemodi

ISSN:1359-107X    

DOI:10.1111/bjhp.12002

年代:2013

数据来源: WILEY

摘要:

ObjectiveTo examine the motivational impact of the addition of a visual image to a personalized health risk assessment and the underlying cognitive and emotional mechanisms.Design and methodsAn online experimental study in which participants (n = 901; mean age = 27.2 years; 61.5% female) received an assessment and information focusing on the health implications of internal body fat and highlighting the protective benefits of physical activity. Participants were randomized to receive this in either (a) solely text form (control arm) or (b) text plus a visual image of predicted internal body fat (image arm). Participants received information representing one of three levels of health threat, determined by how physically active they were: high, moderate or benign. Main outcome measures were physical activity intentions (assessed pre‐ and post‐intervention), worry, coherence and believability of the information.ResultsIntentions to undertake recommended levels of physical activity were significantly higher in the image arm, but only amongst those participants who received a high‐threat communication. Believability of the results received was greater in the image arm and mediated the intervention effect on intentions.ConclusionsThe addition of a visual image to a risk assessment led to small but significant increases in intentions to undertake recommended levels of physical activity in those at increased health risk. Limitations of the study and implications for future research are discussed.Statement of ContributionWhat is already known on this subject?Health risk information that is personalized to the individual may more strongly motivate risk‐reducing behaviour change. Little prior research attention has been paid specifically to the motivational impact of personalized visual images and underlying mechanisms.What does this study add?In an experimental design, it is shown that receipt of visual images increases intentions to engage in risk‐reducing behaviour, although only when a significant level of threat is presented.The study suggests that images increase the believability of health risk information and this may underlie motiva

ISSN:1359-107X    

DOI:10.1111/bjhp.12016

年代:2013

数据来源: WILEY

摘要:

ObjectivesThere is increasing use of counter‐normative health messages (i.e., evidence‐based health information about cause–effect relationships that run counter to shared normative beliefs, e.g., stress can lead to personal growth). The current studies examine the effect of normative and counter‐normative messages about stress on levels of symptom reporting. Predictions are derived from reactance, social comparison, and self‐enhancement theories.Method and designTwo studies focus on the development of the messages, and two experimental studies examine the effect of manipulating normative and counter‐normative messages on symptom reports. The final study controls for mere‐measurement effects and explores the role of stress process variables (appraisals and coping).ResultsExposure to a normative message (stress causes ill health) results in reduced symptom reporting compared to a counter‐normative message (stress provides challenge, growth, and development) and control groups. The results suggest that people may use symptom reporting strategically to indicate coping. Based on the argument that beliefs about stress and health are stored as mental models, the theoretical associations derived from stress theory are only observed when a normative message is presented.ConclusionsCounter‐normative stress messages may carry no tangible benefits compared to normative messages. Some stress research may suffer from inherent methodological bias when normative information is provided in information and consent sheets.Statement of contributionWhat is already known on this subject?At present, nothing is known about counter‐normative health messages, despite the fact that they are becoming widely used as a public intervention.What does this study add?A clear operational definition of counter‐normative messages.A test of three competing theories for counter‐normative messages that focus of the stress–symptom link.Demonstrating for the first time, that in the domain of stress and health, counter‐normative messages are at best ineffective.Demonstrating for the first time that only when the stress–coping–symptom links are made explicit do the theoretical associations observed in the literature emerge. This may be a potential methodological artefact in stress resea

ISSN:1359-107X    

DOI:10.1111/bjhp.12027

年代:2013

数据来源: WILEY

摘要:

ObjectivesThe physical activity (PA) intention–behaviour gap is a topic of considerable contemporary research, given that most of our models used to understand physical activity suggest that intention is the proximal antecedent of behavioural enactment. The purpose of this study was to quantify the intention–PAgap at public health guidelines with a meta‐analysis of the action control framework.DesignSystematic review and meta‐analysis.MethodsLiterature searches were conducted in July 2012 among five key search engines. This search yielded a total of 2,865 potentially relevant records; of these, 10 studies fulfilled the full eligibility criteria (N = 3,899).ResultsRandom‐effects meta‐analysis procedures with correction for sampling bias were employed in the analysis for estimates of non‐intenders who subsequently did not engage in physical activity (21%), non‐intenders who subsequently performed physical activity (2%), intenders who were not successful at following through with theirPA(36%), and successful intenders (42%). The overall intention–PAgap was 46%.ConclusionThese results emphasize the weakness in early intention models for understandingPAand suggest this would be a problem during intervention. Contemporary research that is validating and exploring additional constructs (e.g., self‐regulation, automaticity) that augment intention or improving the measurement of motivation seems warranted.Statement of contributionWhat is already known on this subject?Intention is considered the proximal antecedent of behaviour in many popular models. Intention is also an established correlate of physical activity behaviour, yet discordance is considerable in experimental research.What does this study add?This meta‐analysis of studies that have assessed concordance/discordance of physical activity intention and behaviour at public health guidelines shows the intention–behaviour gap at 48% and the discordance is from intenders who do not act. The results demonstrate that discordance is not just from extreme levels of intention or behaviour (e.g., intend to exercise six times but only exercise five), but from levels that are rel

ISSN:1359-107X    

DOI:10.1111/bjhp.12032

年代:2013

数据来源: WILEY

摘要:

PurposeIncreasing evidence suggests that various health behaviours are amenable to change following the induction of cognitive dissonance. This systematic review sought to evaluate the effectiveness and methodological quality of dissonance‐based health behaviour interventions and to explore identified sources of heterogeneity in intervention effects.MethodsBibliographic databases were searched for relevant articles from inception toMarch 2012. Only studies targeting non‐clinical health behaviour in non‐clinical populations were included in the review. One author extracted data and assessed quality of evidence and a second author verified all content.ResultsReports of 20 studies were included. A variety of health behaviours and outcome measures were addressed across studies. Most studies produced one or more significant effects on measures of behaviour, attitude or intention. Across studies, methodological risk for bias was frequently high, particularly for selection bias. Gender and self‐esteem were identified as potential moderator variables.ConclusionsThe evidence for the effectiveness of dissonance‐based interventions was generally positive. The hypocrisy paradigm was found to be the most commonly applied research paradigm and was most effective at inciting change across a range of health behaviours. There was no observable link between type of target behaviour and positive outcomes. Researchers are encouraged to minimize potential for bias in future studies and explore moderators of the dissonance effect.Statement of contributionWhat is already known on this subject?A recent meta‐analysis indicates that dissonance‐based interventions primarily based on the induced compliance paradigm are effective for eating disorder prevention (Stice, Shaw, Becker,&Rohde, 2008, Prev. Sci., 9, 114). However, it is currently unclear whether such outcomes are generalizable to interventions targeting non‐clinical health behaviours such as smoking, sun protection and sexual risk taking. Other research indicates that studies based on the hypocrisy paradigm may lead to changes in non‐clinical health behaviours (Stone&Fernandez, 2008, Soc. Personal. Psychol. Compass, 2, 1024; Stone&Focella, 2011, Self Identity, 10, 295) although this literature lacks systematic evaluation of interventions across a range of experimental paradigms.What does this study add?The hypocrisy paradigm appears most effective in inciting change across a range of non‐clinical health behaviours.The dissonance effect may be moderated by variables such as self‐esteem and gender.Risk of bias needs to be minimised to increase the validity of studies w

ISSN:1359-107X    

DOI:10.1111/bjhp.12035

年代:2013

数据来源: WILEY

摘要:

ObjectivesHabit formation has been proposed as a means to promote maintenance of healthy behaviours, but there have been few investigations into how habits are formed. This exploratory study sought to model determinants of the formation of a dental flossing habit, including placement of the behaviour within the routine (before vs. after tooth‐brushing), past behaviour, prospective memory ability, and motivational factors.Design and MethodAll participants (N = 50) received a motivational intervention designed to initiate behaviour change and habit formation. Half of the participants were instructed to floss before brushing, and half after. Participants subsequently self‐reported flossing behaviour daily and, 4 weeks later, flossing automaticity. Automaticity and flossing frequency were also measured at 8‐month follow‐up.ResultsParticipants with stronger prospective memory ability, higher levels of past behaviour, and a more positive attitude flossed more frequently during the study. Stronger automaticity was predicted by positive attitudes, and increased behaviour frequency during and prior to the study. Those who flossed after brushing (rather than before) tended to form stronger flossing habits and, at 8‐month follow‐up, had stronger habits and flossed more frequently.ConclusionsHabit forming interventions might usefully consider features of everyday routines and how behaviour may be reinforced. Suggestions for further research using more methodologically rigorous designs are offered.Statement of contributionWhat is already known on this subject?The formation of habit – that is, a learnt automatic response to contextual cues – requires initiation of a behaviour and repetition in a constant context.A recent formation study showed variation in habit strength despite equal repetitions, indicating that factors other than repetition may be important in habit development.From studies of routine behaviour, the boundaries between sub‐routines are characterized by different processes than the middle of sub‐routines, suggesting that placement of behaviour within existing routines may affect the likelihood of habit formation.What does this study add?Greater prospective memory ability predicted more frequent dental flossing.Initiating flossing after rather than before tooth‐brushing promoted stronger habits.Positive attitudes impacted directly on habit formation, independent

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2012.02086.x

年代:2013

数据来源: WILEY

摘要:

ObjectiveExposure to palatable foods in the environment can trigger impulsive reactions to obtain them, which may lead to unhealthy food choices and eating behaviour. Two studies tested the fundamental question whether impulsive unhealthy food choices can be altered by means of linking unhealthy palatable foods to behavioural stop signals.DesignStudy 1 adopted a 2 (signal condition: stop signal vs. control) by 2 (appetite: low vs. high) between‐subjects design. Study 2 adopted a 2 (signal condition: stop signal vs. control) between‐subjects design with frequency to consume unhealthy palatable foods as a continuous factor.MethodsParticipants performed a task in which behavioural stop signals were either consistently (or not) presented in close temporal proximity to unhealthy palatable snack foods. Next, participants were given the opportunity to select snacks that they would like to consume.ResultsTwo studies showed that participants were less likely to select unhealthy palatable foods that had been presented near stop signals, and that they selected healthy foods instead. Importantly, this reduction in choices for palatable foods was especially observed when participants' appetite was relatively high (Study 1), or when this food was part of their habit to frequently consume this food (Study 2).ConclusionThese findings show that a short stop signal intervention in which palatable foods are presented in close temporal proximity of stop signals can reduce palatable food choices by modifying an impulsive determinant of eating behaviour.Statement of contributionWhat is already known on this subject?Exposure to unhealthy palatable foods in the environment can lead to impulsive food choices. People's habits towards unhealthy palatable foods and their current state of appetite are important determinants of such impulsive food choices. This impulsive behaviour is hard to change.What this study add?Linking unhealthy palatable foods to behavioural stop signals reduces choices for these foods, and increases healthy food choices.This effect is particularly strong when people's food choices are driven by their current state of appetite or habits.Behavioural stop signals foster healthy eating behaviour by modifying an impulsive determinant of behavi

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2012.02092.x

年代:2013

数据来源: WILEY

摘要:

ObjectivesThe aim of the study was to explore the relationship between exercise identity and exercise dependence. We hypothesized that stronger exercise identities would be associated with greater odds of experiencing exercise dependence symptoms.DesignLogistic regression was used to assess the extent of association between exercise identity and the risk of experiencing exercise dependence symptoms.MethodParticipants (101) were recruited online via sports clubs and social networking sites and were asked to complete online measures of exercise identity and exercise dependence.ResultsThe overall model fit was a significant improvement on the baseline model, but only the exercise beliefs factor was significantly associated with the odds of dependence symptoms, with higher scores on the belief scale predicting greater odds of experiencing dependence symptoms. Exercise role identity, in contrast, was not significantly associated with odds of experiencing dependence symptoms. Per cent correct classification was 55.9% for asymptomatic and 88.2% for symptomatic individuals and the overall per cent correct classification was 77.5%.ConclusionsThe relation between identity and dependence could represent both a fruitful research avenue and a potential therapeutic target for those experiencing dependence symptoms; although our findings only showed a relationship between one of the two factors of the exercise identity measure and dependence. Longitudinal research is required to examine the relationship between identity and dependence in the context of other variables to better understand why some individuals become exercise dependent whereas others do not.Statement of contributionWhat is already known on this subject?Exercise identity has been identified as an important determinant of exercise behaviour and studies within the exercise identity framework have proven elucidative with respect to the psychological processes that may underpin commitment to exercise.It has separately been established that some individuals may become dependent on exercise and exhibit symptoms indicative of a behavioural addiction to exercise according in line with clinical definitions.What does this study add?Psychological explanation for exercise dependence based on escalation of normal exercise identity processes.Empirical investigation of identity‐dependence link using a sample of physically active individuals.Comparison of two alternative structures for the exercise identity construc

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2012.02091.x

年代:2013

数据来源: WILEY

摘要:

ObjectivesThis study investigated cultural values related to body image and eating practices inWestern and non‐Western societies.Design and MethodsIn total, 628Fijian, 463Indo‐Fijian, 598Tongan, and 534Australian adolescents completed measures of cultural values and religious influences in relation to the ideal body and eating practices.ResultsFijian and Tongan adolescents were more likely to value a large body. Religious influences were most strongly associated with eating practices forFijians,Indo‐Fijians, andTongans.ConclusionsThe findings support the role of religion in transmitting cultural values regarding eating practices inPacificIsland communities.Statement of contributionWhat is already known on this subject?Previous research has demonstrated that sociocultural factors shape body image and eating behaviours.Most of this research has been conducted in Western countries.What does this study add?The current study identifies the role of cultural values and religious influences on body image and eating behaviours in a number of different cultural groups.This is the first study to use the same methodology to explore these relationships across Western and Pacific Island commun

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2012.02090.x

年代:2013

数据来源: WILEY