ISSN:1359-107X    

DOI:10.1111/bjhp.12012

年代:2013

数据来源: WILEY

摘要:

Objective.Research on health‐related behaviour has typically adopted deliberative models of motivation and explicit measures. However, growing support for implicit processes in motivation and health‐related behaviour has caused a shift towards developing models that incorporate implicit and explicit processes.Methods.The current research advances this area by comparing the predictive validity of a newly developed implicit measure of motivation from self‐determination theory (SDT) with explicit measures of motivation for 20 health‐related behaviours, in a sample of undergraduate students (N= 162). A dual systems model was developed to test whether implicit motivation provided unique prediction of behaviour.Results.Structural equation models for each behaviour indicated some support for the role of implicit measures; explicit measures and intention provided more consistent, significant prediction across most behaviours.Conclusions.This study provides some support for dual systems models, and offers an important contribution to understanding why some behaviours may be better predicted by either implicit or explicit measures. Future implications for implicit processes and SDT are outlined.Statement of contributionWhat is already known on this subject? Previous research has highlighted the unique effects of implicit processes on goal‐directed behaviour. Several studies have supported the role of implicit processes in motivation.What does this study add? The current study adds to the previous literature by investigating the role of implicit processes and self‐determination theory. Furthermore, the current study uses a relatively novel implicit measure across a wide range of behaviours. Finally, the current study incorporates a dual‐systems model to provide a conceptual understandin

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2011.02063.x

出版商:Blackwell Publishing Ltd    

年代:2013

数据来源: WILEY

摘要:

Objectives.  We report on the development and psychometric properties of a scale to measure perceived sensitivity to medicines (PSM).Design.  The internal consistency, test–retest reliability, criterion‐related, and predictive validity of the PSM Scale were evaluated using data collected as part of four previously published studies and one unpublished data set.Methods.  Participants (n= 1,166) included patients receiving treatment for HIV infection and hypertension, individuals receiving a travel vaccination, and undergraduate students. Criterion‐related validity was assessed by examining associations between the PSM and beliefs about medicines (Beliefs about Medicines Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale). Predictive validity was assessed by examining associations between the PSM and medication adherence and with symptom reports following vaccination. Test–retest reliability was assessed in an undergraduate sample who completed the PSM on two occasions, 2 weeks apart.Results.  Test–retest reliability was high (r= .89,p<.001). Cronbach's alpha ranged from 0.79–0.94. Consistent with expectations, high PSM scores were associated with negative beliefs about medicines in general, strong concerns about potential adverse effects of prescribed medicines, and doubts about the necessity for treatment. High PSM scores predicted non‐adherence to anti‐retroviral therapy and a higher incidence of symptoms following vaccination.Conclusion.  The findings present preliminary evidence that the PSM is a valid and reliable measure of perceived sensitivity to medication. While further work is needed to develop and evaluate the scale, the findings support its use as a research tool in studies of the use and effects of medicines.Statement of contributionWhat is already known on this subject?It is now well understood that beliefs about medicines have an important influence on whether patients start and continue with treatment. Researchspanning a range of long‐term conditions and across different countries has shown that treatment uptake and adherence are consistently related to specific beliefs about prescribed medicines, suchas how patients judge their personal need relative to concerns about potential adverse effects as well as more general beliefs about medicines as a class of treatment.What does this study add?The paper reports on the development and psychometric properties ofa new scale to measure patients' perceptions of their sensitivity to medicines. In five studies involving different groups of individuals we found the Perceived Sensitivity to Medicines (PSM) Scaleto be a reliable and valid measure. The PSM may be useful for researchers and clinicians in explaining treatment decisions, adherenc

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2012.02071.x

出版商:Blackwell Publishing Ltd    

年代:2013

数据来源: WILEY

摘要:

Purpose.Measuring intentions and other cognitions to perform a behaviour can promote performance of that behaviour (the question‐behaviour effect, QBE). It has been suggested that this effect may be amplified for individuals motivated to perform the behaviour. The present research tested the efficacy of combining a motivational intervention (providing personal risk information) with measuring intentions and other cognitions in a fully crossed 2 × 2 design with an objective measure of behaviour in an at‐risk population using a randomized controlled trial (RCT).Methods.Participants with elevated serum cholesterol levels were randomized to one of four conditions: a combined group receiving both a motivational intervention (personalized cardiovascular disease risk information) and a QBE manipulation (completing a questionnaire about diet), one group receiving a motivational intervention, one group receiving a QBE intervention, or one group receiving neither. All participants subsequently had the opportunity to obtain a personalized health plan linked to reducing personal risk for coronary heart disease.Results.Neither the motivational nor the QBE manipulations alone significantly increased rates of obtaining the health plan. However, the interaction between conditions was significant. Decomposition of the interaction indicated that the combined condition (motivational plus QBE manipulation) produced significantly higher rates of obtaining the health plan (96.2%) compared to the other three groups combined (80.3%).Conclusions.The findings provide insights into the mechanism underlying the QBE and suggest the importance of motivation to perform the behaviour in observing the effect.Statement of ContributionWhat is already known on this subject?Research has indicated that merely asking questions about a behaviour may be sufficient to produce changes in that or related behaviours (referred to as the question‐behaviour effect; QBE). Previous studies have suggested that the QBE may be moderated by the individual's motivation to change the behaviour, i.e., the QBE will only produce increases in the behaviour among those with strong motivation to perform the behaviour. However, no study has directly tested this prediction by manipulating motivation and examining impacts on the QBE.What does this study add?The present study tested the individual and combined effects of a motivational and a QBE intervention in a fully crossed design using a randomized controlled trial (RCT) and showed that:a combined intervention significantly increased behaviour.effect partially mediated by cogn

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2012.02075.x

出版商:Blackwell Publishing Ltd    

年代:2013

数据来源: WILEY

摘要:

Background. Studying and understanding pathways to diagnosis and treatment is vital for the development of successful interventions to encourage early detection, presentation, and diagnosis. An existing framework posited to describe the decisional and behavioural processes that occur prior to treatment (Andersenet al.'s General Model of Total Patient Delay) does not appear to match the complex and dynamic nature of the pathways into and through the health care system or provide a clear framework for research. Therefore a revised descriptive framework, theModel of Pathways to Treatment,has been proposed.Purpose. This paper presents the concepts and definitions of theModel of Pathways to Treatmentand specifies how the model can encompass existing psychological theory, with particular focus on the Appraisal and Help‐seeking intervals. The potential and direction for future work is also discussed.Statement of contributionWhat is already known on this subject?• The use of theory is often lacking in existing research into delays in presentation, diagnosis and treatment of illness.What does this study add?• A detailed account of the concepts and definitions of a revised framework: theModel of Pathways to Treatment.• Specification of how theModel of Pathways to Treatmentcan encompass existing psychological theory such as the Common Sense Model of Illness Self‐regulation and Soci

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2012.02077.x

出版商:Blackwell Publishing Ltd    

年代:2013

数据来源: WILEY

摘要:

Objectives.This study examined the ways in which body mass index (BMI) percentile – an identified risk factor for overweight and cardiovascular disease in adulthood – develops from birth through early adolescence. In addition, we examined whether psychosocial factors, such as parenting style and maternal depression, mediated the link between socio‐economic status (SES) and BMI growth.Design.Data were obtained from phases 1–3 of the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCYD) – a longitudinal study that followed children from 10 communities in the United States from birth to age 11.Methods.We applied growth mixture models to identify distinct subtypes of BMI development. Within these models, we performed between‐ and within‐class mediation analyses to examine whether SES predicted class membership or differences in development within each class via maternal depression and parenting styles.Results.Results identified three prototypic trajectories of BMI percentile growth,elevated,steady increase, andstable. We found evidence for both between‐ and within‐class mediation, suggesting multiple pathways by which SES can affect BMI development.Conclusions.These findings add to the research that suggests that being in a family with a low SES is associated with falling into patterns of development characterized by early and lasting increases in BMI relative to one's peers, and that this association is partly accounted for by maternal depression and parenting styles.Statement of ContributionWhat is already known?Past research has found evidence that patterns of childhood overweight are impacted by socioeconomic status through psychosocial factors like parenting and depression. This evidence is often limited to individual points in time where neglectful, permissive, and authoritarian parenting and higher levels of maternal depression are associated with higher levels of overweight status among children from infancy to adolescence. However, little research has linked together whether the children who receive non‐authoritative parenting and are overweight in infancy are the same children who are overweight in adolescence.What does this study add?• Evidence for 3 different prototypes of BMI percentile growth over the course of childhood approaching adolescence.• Adds complexity re the influence of parenting styles as an influence on patterns of weight gain.• Buttresses existing research as to early and lasting ef

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2012.02078.x

出版商:Blackwell Publishing Ltd    

年代:2013

数据来源: WILEY

摘要:

Objectives.Cardiac patients have been shown to have inaccurate understanding of their cardiovascular risk. The purpose of the study was to investigate whether a guideline‐based risk assessment and management intervention could facilitate understanding of cadiovascular risk and appropriate illness perceptions in cardiac patients.Design.Randomized trial.Methods.A total of 106 patients with MI or unstable angina were randomized to receive standard care with or without a 30‐min nurse‐led computerized Predict CVD‐Diabetes (where CVD is cardiovascular disease) session. Patients’ risk perceptions (using categorical and numerical measures), and perceptions of their heart condition were assessed at admission, discharge, and 3 months.Results.The intervention group rated the risk information as more easily understood than the control group. At discharge, they had increased perceptions of personal control, higher perceptions that a low‐fat diet and regular exercise could help their condition, and believed their current illness would be shorter compared to the control group. At 3 months, no group differences were significant. The intervention had no effect on risk perceptions, which were high in both groups. Patients’ perceptions of ‘high’ risk corresponded to numerical estimates of over 50%, which differs from clinical guidelines (over 20%).Conclusions.A computerized cardiovascular risk assessment and management session can help acute coronary syndrome patients understand CVD risk information and improve perceptions of control in the short term, but not change risk perceptions. In‐hospital risk factor assessment and management information may help patients understand the importance of key lifestyle changes.Statement of contributionWhat is already known on this subject?• Many members of the public, as well as patients with diagnosed coronary heart disease (CHD), have poor understanding of their cardiovascular disease risk.• Giving risk information can improve accuracy of risk perceptions, and may increase intentions to start preventive risk reduction treatments but more research is needed with patients with established CHD.What does this study add?• Providing acute coronary syndrome patients with individualised risk assessment and risk management information may be beneficial over the short term by increasing patients' perceptions of control and the importance of key lifestyle changes.• A difficulty in communicating cardiovascular risk levels is the poor correspondence between patients' understanding of very high risk and the cl

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2012.02081.x

出版商:Blackwell Publishing Ltd    

年代:2013

数据来源: WILEY

摘要:

Objectives.Lazarus's Transactional Model of stress and coping underwent significant theoretical development through the 1990s to better incorporate emotional reactions to stress with their appraisal components. Few studies have robustly explored the full model. This study aimed to do so within the context of a major life event: cancer diagnosis.Design.A repeated measures design was used whereby data were collected using self‐report questionnaire at baseline (soon after diagnosis), and 3‐ and 6‐month follow‐up.Methods.A total of 160 recently diagnosed cancer patients were recruited (mean time since diagnosis = 46 days). Their mean age was 64.2 years. Data on appraisals, core‐relational themes, and emotions were collected. Data were analysed using both Spearman's correlation tests and multivariate regression modelling.Results:Longitudinal analysis demonstrated weak correlation between change scores of theoretically associated components and some emotions correlated more strongly with cognitions contradicting theoretical expectations. Cross‐sectional multivariate testing of the ability of cognitions to explain variance in emotion was largely theory inconsistent.Conclusions.Although data support the generic structure of the Transactional Model, they question the model specifics. Larger scale research is needed encompassing a wider range of emotions and using more complex statistical testing.Statement of ContributionWhat is already known on this subject?• Stress processes are transactional and coping outcome is informed by both cognitive appraisal of the stressor and the individual's emotional response (Lazarus&Folkman, 1984).• Lazarus (1999) made specific hypotheses about which particular stress appraisals would determine which emotional response, but only a small number of these relationships have been robustly investigated.• Previous empirical testing of this theory has been limited by design and statistical limitations.What does this study add?• This study empirically investigates the cognitive precedents of a much larger range of emotional outcomes than has previously been attempted in the literature.• Support for the model at a general level is established: this study demonstrates that both primary and secondary appraisals, and core‐relational themes are important variables in explaining variance in emotional outcome.• The specific hypotheses proposed by Lazarus (1999) are not, however, supported: using data‐driven approaches we demonstrate that equally high levels of variance can be explained using entirely different cogni

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2012.02082.x

出版商:Blackwell Publishing Ltd    

年代:2013

数据来源: WILEY

摘要:

ObjectiveCommonly used theories in health psychology involve multiplicative composites of measures, which have been used as predictors, mediators, and outcomes. The chosen scaling system can affect correlations with other variables. This study evaluated how best to construct composites in the context of the theory of planned behaviour (TPB), using hierarchical linear regression, a priori defined scaling systems, and optimal scaling.DesignLongitudinal.MethodsAt baseline, 6 and 12 months, 365 trial participants (ProActive) completed questionnaires assessing salient beliefs, which were used to construct composites (indirect measures), and direct measures of instrumental and affective attitude, subjective norm, and perceived behavioural control towards becoming more physically active over the next 12 months.ResultsLinear regression supported a multiplicative model for indirect instrumental attitude and perceived control. Except for perceived control, associations between composites and direct measures were unaffected by differenta prioriscaling systems. Optimal scaling produced widely differing composites over time for subjective norm and affective attitude and a negative association between composite and direct measure for subjective norm.ConclusionsWe recommend that researchers who use multiplicative composites first establish clear support for a multiplicative model, before they examine a range of meaningful scaling systems on theoretical and empirical grounds. Caution is needed when using optimal scaling without checking that a multiplicative model is supported and the resulting scaling system meaningful.Statement of contributionWhat is already known on this subject?Multiplicative composites are included in commonly used theories in health psychology (e.g., theory of planned behaviour). Valid measures are needed as the choice of scaling system (e.g., unipolar or bipolar) can affect estimates of associations between composites and other variables. Ajzen has advocated the use of optimal scaling.What does this study add?The study shows that optimal scaling can result in meaningless measures. We recommend that health psychologists use optimal scaling with great caution and we provide alternative recommendations for constructing composite

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2012.02095.x

年代:2013

数据来源: WILEY

摘要:

ObjectivesCompensatory health beliefs are hypothesized to be a means by which people compensate for the negative effects of performing an unhealthy behaviour by engaging in a health‐protective behaviour (Knäuper, Rabiau, Cohen,&Patriciu, 2004). However, the measurement of compensatory health beliefs has proven problematic (e.g., Radtke, Scholz, Keller, Perren,&Hornung, 2010) and so the aims of the present study are to identify: (a) the kinds of difficulties that people experience when completing compensatory health belief scales; and (b) what steps will be required to develop a future reliable and valid measure of compensatory health beliefs.DesignCross‐sectional survey.MethodsForty‐three participants (M = 34.98 years,SD = 13.94) completed the compensatory health beliefs questionnaire while thinking aloud. Participants' responses to the compensatory health beliefs scale were coded using French, Cooke, McLean, Williams, and Sutton's (2007) schedule.ResultsConsistent with prior research, the full compensatory health beliefs scale showed evidence of internal reliability, and face validity. Participants identified several conceptual ambiguities, most notably: (a) between belief‐ and behaviour‐based compensation (i.e., participants did not believe in the compensatory health belief, but still engaged in the affiliated compensatory behaviour), and (b) the ‘effectiveness’ of the beliefs (i.e., participants talked about engaging in the compensatory behaviour, but acknowledged that it was only a partial solution).ConclusionsAlthough the compensatory health belief subscales lack reliability, the measure as a whole possesses face validity. Further work is required to refine the compensatory health beliefs scale by discriminating between compensatory health beliefs and compensatory health behaviours.Statement of contributionWhat is already known on this subject?Although the idea that people use compensatory health beliefs as a strategy to continue engaging in unhealthy behaviours is an appealing one, attempts to measure compensatory health beliefs has produced mixed findings (see Kaklamanou&Armitage, [Kaklamanou, D., 2012]; Knäuperet al., [Knäuper, B., 2004]; Nooijer, Puijk‐Hekman,&Assema, [De Nooijer, J., 2009]; Radtkeet al., [Radtke, T., 2011]).What does this study add?The present study, using a ‘think aloud technique’, suggests ways to improve reliability of the compensatory health beliefs scale. We suggest that three sub‐strategies underpin the ‘activate Compensatory Health Beliefs’ strategy. We propose a new construct that we ca

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2012.02097.x

年代:2013

数据来源: WILEY