Two alternative models of health behaviour and recovery from activity limitations due to acute injury: A prospective study

Cognitions influence recovery from activity limitations. In this study we aimed to independently test, compare and combine the common sense self-regulation model (CS-SRM) and social cognitive theory (SCT) in predicting recovery from activity limitations due to acute injury. Measures were gathered at two time points 5–6 weeks apart. The sample consisted of 146 university students (Mean age: 21.86, SD: 4.83, 62% female) with a heterogeneous range of injuries that limited their participation in physical activity. The dependent variable was recovery from activity limitations (Physical Functioning?–?Short Form-36). The predictor variables were measured using the Brief Illness Perception Questionnaire and SCT items designed according to theoretical recommendations. Time-line (TL) and self-efficacy (SE) were significant predictors of recovery in a multivariate analysis, controlling for reported pain at Time 1. A combined model including the best predictors from both models, TL (β = ?0.25, p < 0.05, R ² change = 0.17, p < 0.01) and SE (β =0.31, p < 0.05, R ² change = 0.05, p < 0.05), accounted for a significant amount of the variance in recovery from activity limitations. A combination of key variables from both models may be particularly useful for understanding the cognitive factors that influence recovery from activity limitations.     

Toward Reducing Risk for Eating Disorders and Obesity in Latina College Women

The efficacy of 2 computer‐based programs was tested with Latina college women (N= 64). Compared with participants in the control group, intervention participants improved their motivation to eat fruits and vegetables (F&V; p= .042) and to participate in physical activity (p= .023) and significantly increased their F&V intake (pre‐ to posttest, p < .001; pre‐follow‐up, p= .002). Body dissatisfaction improved at a trend level (p= .055). Some modest effects of computer‐based programs were found.     

Parenting Intervention to Reduce Attention and Behavior Difficulties in Preschoolers: A CUIDAR Evaluation Study

In this study, we evaluated CUIDAR, a program that provides community-based 10-week parent training to reduce attention and behavior problems in preschool children. We recruited 154 predominantly low-income and Latino preschoolers and their parents to participate in this evaluation study. We collected data prior to and immediately following intervention and one year later. At the time of follow-up, we also recruited 15 parents who had initially enrolled, but never participated in the program to serve as a comparison group for a limited set of analyses. From pre to post intervention, we observed significant, positive changes in eight out of ten measured parenting behaviors. From pre intervention to follow-up, improvements in the use of transitional statements and planning ahead were significant. Children’s SDQ Total Difficulties scores significantly decreased from pre to post intervention (d = .36), and we observed significant, positive changes in all SDQ subscales. From pre intervention to follow-up, children’s SDQ Total Difficulties scores significantly decreased (d = .71) and all SDQ subscales reflected significant, positive changes. We observed no significant differences in reported barriers to participation between parents who participated in the program and those who enrolled, but never participated. Intervention gains were moderated by several factors, including history of out-of-home care and family structure. Our results should be interpreted cautiously because not all analyses included a comparison group, and a randomized trial of CUIDAR effectiveness is still needed.     

Unrealistic optimism and genetic risk

The study examined whether life stress moderated the effects of a physical activity intervention. Women (n = 184) and 154 men (61% non-Hispanic white, average age 24 years) from an urban university participated. Data were analyzed separately for men and women using a 2 × 2 ANCOVA adjusting for baseline physical activity (intervention vs. control × high life stress vs. low stress) with total physical activity at one-year and two-year assessments as dependent variables. No significant main effect for stress or condition was found. The interaction was significant (p = 0.015) for men at one-year, indicating that men in the intervention group with high stress were more active than low stress intervention men. Instruction received in the intervention group on the stress-relieving properties of physical activity may have helped men with high stress to adopt or maintain physical activity.     

Does a self management intervention lower distress in woman diagnosed with breast cancer?1

Psychological distress is particularly common with any cancer diagnosis. This paper examined the psychological distress in a cohort of women newly diagnosed with breast cancer and postulates on the underlying theory. A longitudinal study of a cohort of women (n = 147) diagnosed with breast cancer (within the past 1 year), was conducted at University Malaya Medical Centre, Kuala Lumpur. Data were collected at baseline and at post 4‐week intervention. Analysis of variance was conducted to examine for any significant differences in the change‐scores between the experimental group (n = 69) and the control group (n = 78). Using the change scores, analyses of variance showed significant differences between groups for stress, F(1, 140) = 13.68, p < .0001, anxiety F(1, 140) = 8.44, p < .004, and depression, F(1, 140) = 11.57, p < .0001. Levels of stress, anxiety and depression generally decreased significantly in the experimental groups, p < .05, but either maintained or increased in the control group. This study indicates that the level of psychological distress of women with breast cancer can be ameliorated with a 4‐week self‐management intervention. Lower stress levels were also found in women who reported engagement in higher physical activity than women with low physical activity.     

Test of a brief theory of planned behaviour‐based intervention to promote adolescent safe sex intentions

The present study tested a brief (303 word) intervention designed to change attitude, subjective norm, and perceived behavioural control regarding a safe sex behaviour in a sample of 16‐ to 18‐year‐olds. Participants (N = 288) were randomized to receive either an experimental intervention or a control (knowledge only) intervention and completed measures of their reactions to the stimuli as well as pre‐ and post‐test measures of theory of planned behaviour variables. The experimental intervention significantly increased message processing (mean between‐group difference = 0.73, 95% CI = 0.40, 1.06; Cohen's d = .52), message acceptance (mean between‐group difference = 0.82, 95% CI = 0.57, 1.07; Cohen's d = .77), subjective norm (adjusted Mean between‐group difference = 0.54, 95% CI = 0.26, 0.81; Cohen's d = .37; mean within‐group difference for intervention condition = 0.59, 95% CI = 0.36, 0.81; Cohen's d = .38) and intention (adjusted Mean between‐group difference = 0.27, 95% CI = 0.02, 0.53; Cohen's d = .20; mean within‐group difference for intervention condition = 0.54, 95% CI = 0.33, 0.75; Cohen's d = .31), but not attitude or perceived behavioural control. The effects of the experimental intervention on intention were mediated solely through subjective norm. The present findings: (a) compare favourably in terms of the effect sizes reported in previous research in this area (mean Cohen's d for within‐group difference for intervention conditions = .009 and .09, for norms and intention, respectively, see Albarracín et al. (2003) ), (b) imply that subjective norms are causally related to intentions, and (c) suggest that interventions designed to change subjective norms (as opposed to communication of risks and fear appeals) might ultimately be effective in changing behaviour.     

Motivation for physical activity in young adults with physical disabilities during a rehabilitation stay: a longitudinal test of self‐determination theory

We tested a self‐determination theory (SDT) process model during a 3 week physical activity rehabilitation stay among young adults with a physical disability (N = 44, M_age = 24.7, SD = 5.1). As hypothesized, perceived autonomy support positively predicted needs satisfaction at the end of the stay (r = .38, p < .01). Further, needs satisfaction was positively linked to changes in autonomous motivation for physical activity (r = .47, p < .01). Both changes in autonomous motivation and self‐efficacy were associated with physical activity increases over the stay (r = .57, p < .01 and r = .47, p < .01, respectively). Bootstrapping results supported the SDT process model, indicating a support for a development toward more self‐determined motivation in rehabilitation.     

Testing motivational and self-regulatory mechanisms of action on device-measured physical activity in the context of a weight loss maintenance digital intervention: A secondary analysis of the NoHoW trial

BackgroundTo date, few digital behavior change interventions for weight loss maintenance focusing on long-term physical activity promotion have used a sound intervention design grounded on a logic model underpinned by behavior change theories. The current study is a secondary analysis of the weight loss maintenance NoHoW trial and investigated putative mediators of device-measured long-term physical activity levels (six to 12 months) in the context of a digital intervention.MethodsA subsample of 766 participants (Age = 46.2 ± 11.4 years; 69.1% female; original NoHoW sample: 1627 participants) completed all questionnaires on motivational and self-regulatory variables and had all device-measured physical activity data available for zero, six and 12 months. We examined the direct and indirect effects of Virtual Care Climate on post intervention changes in moderate-to-vigorous physical activity and number of steps (six to 12 months) through changes in the theory-driven motivational and self-regulatory mechanisms of action during the intervention period (zero to six months), as conceptualized in the logic model.ResultsModel 1 tested the mediation processes on Steps and presented a poor fit to the data. Model 2 tested mediation processes on moderate-to-vigorous physical activity and presented poor fit to the data. Simplified models were also tested considering the autonomous motivation and the controlled motivation variables independently. These changes yielded good results and both models presented very good fit to the data for both outcome variables. Percentage of explained variance was negligible for all models. No direct or indirect effects were found from Virtual Care Climate to long term change in outcomes. Indirect effects occurred only between the sequential paths of the theory-driven mediators.ConclusionThis was one of the first attempts to test a serial mediation model considering psychological mechanisms of change and device-measured physical activity in a 12-month longitudinal trial. The model explained a small proportion of variance in post intervention changes in physical activity. We found different pathways of influence on theory-driven motivational and self-regulatory mechanisms but limited evidence that these constructs impacted on actual behavior change. New approaches to test these relationships are needed. Challenges and several alternatives are discussed.Trial registrationISRCTN Registry, ISRCTN88405328. Registered December 16, 2016, https://www.isrctn.com/ISRCTN88405328.     

An investigation of psychosocial factors related to changes in physical activity and fitness among female adolescents

Research examined the effects of a supervised physical activity program on potential psychosocial mediators and determined whether changes in these psychosocial variables predicted changes in physical activity and fitness. Sedentary adolescent females were assigned to an intervention (n?=?79) or comparison (n?=?67) group. Cardiovascular fitness (cycle ergometer), physical activity (3-Day Physical Activity Recall), and psychosocial variables related to physical activity (i.e., self-efficacy, perceived barriers, social support, enjoyment) were assessed at three time points over the 9-month study. An intention-to-treat analysis showed that the intervention did not impact any of the psychosocial variables, with the exception of perceived barriers, which increased in the intervention group. Longitudinal analyses showed that improvements in fitness were associated with positive changes in global self-efficacy and exercise enjoyment. Psychosocial variables did not mediate the program's effects on fitness or activity. However, individual level changes in psychosocial variables were related to changes in cardiovascular fitness.     

Understanding physical activity in individuals with prediabetes: an application of social cognitive theory

Despite well-documented evidence implicating physical activity (PA) in the prevention of type 2 diabetes, the overwhelming majority of individuals with prediabetes are not physically active enough. The purpose of this study was to investigate the applicability of the social cognitive theory (SCT) in understanding PA behaviour in individuals with prediabetes. Individuals with prediabetes (N = 232) completed a mailed questionnaire assessing demographics, self-reported PA (MET.min/wk) and SCT constructs for PA MET.min/wk. For PA MET.min/wk, scheduling and task efficacy both had significant effects on PA (β = .30 and .22, respectively). Goal formation also had a direct effect on PA for scheduling, coping and task efficacy (β = .20, .34 and .30, respectively). Task, coping and scheduling efficacy explained a significant portion of the variance in PA behaviour. Overall, SCT appears to have merit as a model for understanding PA in individuals with prediabetes. Further evaluative inquiry is needed to establish support for the use of the SCT as a framework for developing, implementing and evaluating PA behaviour change interventions in this population.     

Social cognitive theory correlates of moderate-intensity exercise among adults with type 2 diabetes

The purpose of this study was to identify social cognitive theory (SCT) correlates of moderate- to vigorous-intensity exercise (MVPA) among adults with type 2 diabetes. Adults with type 2 diabetes (N = 181) participated in the study. Participants were recruited through ResearchMatch.org to complete an online survey. The survey used previously validated instruments to measure dimensions of self-efficacy, self-regulation, social support, outcome expectations, the physical environment, and minutes of MVPA per week. Spearman Rank Correlations were used to determine the relationship between SCT variables and MVPA. Classification and Regression Analysis using a decision tree model was used to determine the amount of variance in MVPA explained by SCT variables. Due to low levels of vigorous activity, only moderate-intensity exercise (MIE) was analyzed. SCT variables explained 42.4% of the variance in MIE. Self-monitoring, social support from family, social support from friends, and self-evaluative outcome expectations all contributed to the variability in MIE. Other contributing variables included self-reward, task self-efficacy, social outcome expectations, overcoming barriers, and self-efficacy for making time for exercise. SCT is a useful theory for identifying correlates of MIE among adults with type 2 diabetes. The SCT correlates can be used to refine diabetes education programs to target the adoption and maintenance of regular exercise.     

A psychological intervention reduces doping likelihood in British and Greek athletes: A cluster randomized controlled trial

BackgroundCurrent attempts to prevent doping through deterrence and education have had limited success and have been constrained to one country. Targeting psychological variables that have been empirically associated with doping likelihood, intention, or behaviour may help in developing interventions that are effective in preventing doping in sport.ObjectivesGuided by social cognitive theory and empirical research, the main purpose of this research was to develop an anti-doping intervention that targets three psychological variables (i.e., anticipated guilt, moral disengagement, and self-regulatory efficacy) and determine whether it is more effective than an educational intervention in reducing doping likelihood in British and Greek athletes.MethodEligible participants were identified via a screening survey administered to 934 athletes in the United Kingdom and Greece. A total of 19 sport clubs (208 athletes) across the two countries were randomly assigned to either the psychological or the educational intervention. Each intervention consisted of six 1-h sessions delivered to small groups of athletes over 6–8 weeks. Athletes completed measures of doping likelihood, anticipated guilt, moral disengagement, and self-regulatory efficacy pre and postintervention and at a 2-month follow-up.ResultsA multilevel piecewise growth model was used to examine changes in study outcomes. Analysis showed that the psychological intervention was more effective than the educational intervention in reducing doping likelihood from pre to post, but the effects of the two interventions were similar at follow-up. These effects were not affected by country. Both interventions reduced moral disengagement from pre to post, and these effects were maintained at follow-up. The psychological intervention was also more effective than the educational intervention in increasing anticipated guilt from pre to follow-up.ConclusionsTargeting psychological variables in anti-doping interventions should aid our efforts to prevent doping in sport.     

Social cognitive correlates of physical activity among single mothers with young children

ObjectivesSingle mothers experience negative health consequences that might be reduced through participation in physical activity, yet little is known about physical activity correlates among this population. This study examined social cognitive theory (SCT) correlates of physical activity among single mothers with young children.DesignCross-sectional.MethodSingle mothers (N = 94) with at least one child less than 5 years old completed SCT questionnaires, wore an accelerometer for one week, and then completed the Godin Leisure Time Exercise questionnaire. Physical activity scores were standardized and averaged to yield a composite physical activity score.ResultsRegression analysis indicated that self-efficacy was a direct predictor of composite physical activity; in the final model planning was the only statistically significant predictor of composite physical activity scores.ConclusionsPlanning and self-efficacy might be important factors to include when designing physical activity interventions for single mothers.     

CAMP: A community‐based approach to promoting safe sex behaviour in adolescence

The primary goal of this study was to describe the development and assessment of the Community Awareness Motivation Partnership (CAMP) Teen Theatre intervention. Based on the behavioural ecological model, CAMP addressed the role of contraceptive use in safe sex behaviour through a brief informative, entertaining, and culturally responsive dramatization programme. Adolescents (N = 1613) between the ages of 11 and 18 (M = 13.31, SD = 0.76) received the intervention, and 961 participants completed both pre‐ and post‐tests. The majority of participants were Latino (78.5%, n = 1039), many of whom were first generation immigrants. Results indicated that the intervention increased participants' reported intentions to delay sex and use contraceptives. The intervention produced short‐term changes in safe‐sex behavioural intentions and knowledge. Suggestions for producing long‐term changes were discussed. Copyright © 2003 John Wiley & Sons, Ltd.     

Effects of action planning and coping planning within the theory of planned behaviour: A physical activity study of patients undergoing haemodialysis

Objective

Patients on dialysis have low physical activity levels. The aim of the study was to examine the validity of action planning and coping planning within the theory of planned behaviour framework, for predicting physical activity behaviour of patients on haemodialysis.

Design

This is a prospective study design.

Methods

One hundred and forty-four patients who were undergoing haemodialysis were selected from dialysis centres. The mean age of the patients was 56.61 (SD = 11.38) years. The patients completed a questionnaire including variables from the theory of planned behaviour, action planning and coping planning. Physical activity was prospectively assessed at 4-weeks with the validated International Physical Activity Questionnaire self-report measure. A hierarchical regression analysis was performed to examine the effects of action planning and coping planning on physical activity behaviour.

Results

There was a main effect for coping planning but not for action planning. Moreover, the analyses resulted in a significant amount of incremental variance accounted for by the interaction of coping planning and intention.

Conclusion

Results suggest the combination of high levels of coping planning and intention is associated with increases in physical activity.     

Cognitive mediation of intervention effects on physical exercise: Causal models for the adoption and maintenance stage

Objective: To investigate how the effects of a group-based intervention program (MoVo-LISA) on exercise behaviour were mediated by cognitive variables. Different causal models mapping the short-term (adoption) and long-term (maintenance) intervention effects were tested using path analyses.

Design: N?=?220 in-patients of a rehabilitation clinic were assigned to an usual care or intervention group (quasi-experimental design). Questionnaire-based assessment was conducted at baseline; discharge; and at six weeks, six months and 12 months post discharge.

Measures: The potential mediator variables were outcome expectations, self-efficacy, strength of goal intention (intention strength), self-concordance, action planning and barrier management.

Results: Observed intervention effects on exercise behaviour (p?<?0.05) were mediated by intention strength at the adoption and maintenance stages, by action planning only at the adoption, and by barrier management only at the maintenance stage. Self-efficacy and outcome expectations were only indirectly involved in these mediations by affecting intention strength and self-concordance.

Conclusion: This is the first study to track the cognitive mediation processes of intervention effects on exercise behaviour over a long time-period by differentiating the adoption and maintenance stages of behaviour change. The findings emphasise the importance of deconstructing intervention effects (modifiability vs. predictive power of a mediator) to develop more effective interventions.     

The Simple Copy Task: Detecting Higher Order Visual Processing Deficits in Schizophrenia,Dementia, and Movement Disorder Groups

The Simple Copy Task (SCT) is a figure copying test with inherent appeal due to its short administration time, graded task difficulty, varied stimuli, and potential to eliminate floor effects. Despite this, there is a lack of data regarding its construct validity and diagnostic utility. The present study compared SCT performance of schizophrenia (n = 29), dementia (n = 64), and movement disorder (n = 12) groups with that of unmatched healthy control participants (n = 49). Movement disorder patients committed a high degree of misplacement errors, whereas dementia patients tended to omit items, add extraneous detail, and perseverate. The schizophrenia group was most similar to the dementia group in their performance on the SCT, committing primarily omission and perseveration errors. The SCT was most closely related to the Rey Complex Figure Task (r = 0.68, p < .01) and the Block Design Task (r = 0.62, p < .01). Age (r = ?0.14, p < .01) and education (r = 0.35, p < .01) effects were present; however, there was no impact of gender and handedness. Taken together, these findings provide support for the utility of the task and directions for clinical interpretation.     

Stress related changes in immunological and psychological variables induced by the preparation and defense of a PhD-thesis

Abstract

Results are reported from a field study on 47 healthy subjects preparing and defending a PhD-thesis in the Netherlands. Measurements before, about and after thesis defense are used to quantify the temporal effects of this perceived stressor on immunological and psychological variables. Moreover, multivariate analysis of variance for repeated measurements was used to explore a potential causal relationship between changes in immune variables and changes in psychological variables. Significant temporal effects were observed for the immunological variables, percentage CD4 cells (p = 0.037), the proliferative response to pokeweed mitogen (p = 0.040), concanavalin A 10 μg/ml (p = 0.010) and concanavalin A 40 μg/ml (p = 0.005) and the psychological variables, average subjective distress (p = 0.002), highest subjective distress (p = 0.000) and the coping strategy depressive reaction pattern (p= 0.02). No evidence was obtained for a causal relation between the immunological and psychological variables.     

Feasibility and acceptability of an exergame intervention for schizophrenia

ObjectivesTo evaluate the feasibility and acceptability of an exergame intervention as a tool to promote physical activity in outpatients with schizophrenia.DesignFeasibility/Acceptability Study and Quasi-Experimental Trial.MethodSixteen outpatients with schizophrenia received treatment as usual and they all completed an 8-week exergame intervention using Microsoft Kinect^® (20 min sessions, biweekly). Participants completed pre and post treatment assessments regarding functional mobility (Timed Up and Go Test), functional fitness performance (Senior Fitness Test), motor neurological soft signs (Brief Motor Scale), hand grip strength (digital dynamometer), static balance (force plate), speed of processing (Trail Making Test), schizophrenia-related symptoms (Positive and Negative Syndrome Scale) and functioning (Personal and Social Performance Scale). The EG group completed an acceptability questionnaire after the intervention.ResultsAttrition rate was 18.75% and 69.23% of the participants completed the intervention within the proposed schedule. Baseline clinical traits were not related to game performance indicators. Over 90% of the participants rated the intervention as satisfactory and interactive. Most participants (76.9%) agreed that this intervention promotes healthier lifestyles and is an acceptable alternative to perform physical activity. Repeated-measures MANOVA analyses found no significant multivariate effects for combined outcomes.ConclusionThis study established the feasibility and acceptability of an exergame intervention for outpatients with schizophrenia. The intervention proved to be an appealing alternative to physical activity. Future trials should include larger sample sizes, explore patients' adherence to home-based exergames and consider greater intervention dosage (length, session duration, and/or frequency) in order to achieve potential effects.     

Post‐retirement work: The individual determinants of paid and volunteer work

This research investigates the prediction of post‐retirement work. Unlike prior research, we examined both paid and volunteer post‐retirement work, showing the similarities and differences in their prediction. Using multinomial logistic regression analysis, a framework based on image theory was tested, which included evaluations of pre‐retirement work, attitudes to retirement, behavioural style and demographics, and used to predict both intentions to work in retirement in a pre‐retiree sample (N = 987) and actual work in retirement in a sample of retirees (N = 725). Both volunteer and paid post‐retirement work were strongly related to people's evaluation of their pre‐retirement work and for pre‐retirees, a proactive style of behaviour was also predictive. However, gender, health and retirement satisfaction more related to volunteer work and education to paid work.