Association of hypertension-related distress with lack of self-care among hypertensive patients

Research on factors associated with poor adherence to self-care focuses primarily on psychiatric emotional disorders such as depression and anxiety, whereas non-psychiatric chronic-disease-related emotional distress has received little attention in hypertensive patients. The objective of this study was to evaluate the association of hypertension-related distress with the lack of self-care including low adherence to pharmacological treatment, lack of regular physical activity, low intake of fruits and vegetables and frequent intake of high-salt foods. A cross-sectional survey was conducted in 2014 in two family medical units affiliated with the Mexican Institute of Social Security. The study included 487 hypertensive patients >19 years of age. The conceptual framework for the study was based on the Health Promotion Model. The analysis included multiple Poisson regression models. We found that 21.1% of participants had hypertension-related distress. Low adherence to pharmacological treatment was identified in 45.8% of patients, whereas 46.8% lacked regular physical activity, 30.8% reported a low consumption of fruits and vegetables, and 54.6% frequently consumed foods high in salt content. Hypertension-related distress was associated with lack of regular physical activity and low intake of fruits and vegetables. These findings highlight the importance of addressing distress in order to improve self-care of hypertensive patients.     

Dietary consumption and happiness and depression among university students: A cross-national survey

The aim of this study was to evaluate the relationships between fruit and vegetable consumption and happiness and depression among university students in a cross-national survey. Using anonymous questionnaires, data were collected from 18 522 undergraduate university students (mean age 20.9, SD = 2.4) from 29 universities in 28 countries across Asia, Africa, and the Americas. Results indicate that the amount of fruit and vegetable consumption was positively associated with happiness and inversely associated with depression. Healthier behaviour patterns of fruit and vegetable consumption was associated with higher happiness and lower depression scores among university students across 28 countries.     

Comparing implementation intention interventions in relation to young adults’ intake of fruit and vegetables

This study tests whether the effectiveness of implementation intention-based interventions to increase fruit and vegetable intake in a young adult population can be enhanced using additional pre-intervention instructions and alternative formats; namely, an ‘if-then’ implementation intention versus a more general, ‘global’ plan that does not explicitly link a situational cue with a goal-directed response. Participants (N?=?557) completed pre-test measures of planning, motivation and behaviour with respect to increasing their fruit and vegetable intake before being randomised to a 3 (intervention format: control vs. ‘if-then’ vs. ‘global’ implementation intentions)?×?2 (pre-intervention instruction vs. no pre-intervention instruction) between-participants design. Results revealed a significant intervention format by time interaction, such that intake significantly increased by 0.50 portions in the if-then format condition compared with 0.31 in the global format and 0.01 in the control condition. These results suggest that ‘if-then’ manipulations are superior in promoting behaviour change in an applied setting. The use of pre-intervention instructions had no additional effect on behaviour, providing evidence for the efficacy of implementation intentions even when experimenter demand is reduced. Evidence is also presented to suggest that reported increases in intake are not related to demand characteristics.     

The impact of self-efficacy and implementation intentions-based interventions on fruit and vegetable intake among adults

This study tested the effect of interventions designed for people who do not eat yet the recommended daily fruit and vegetable intake (FVI) but have a positive intention to do so. Adults (N?=?163) aged 20–65 were randomised into four groups: implementation intentions (II group), self-efficacy (SE group), combination of II?+?SE group) and a control group receiving written information on nutrition. Study variables were measured at baseline, post-intervention and at 3-month follow-up. At follow-up, compared to the control group, FVI increased significantly in the II and II?+?SE groups (1.5 and 1.9 servings per day, respectively). Most psychosocial variables significantly increased compared to the control group, with the exception of SE for vegetable intake (VI). Moreover, at 3-month follow-up, change in FVI was mediated by changes in fruit intake (FI) intention and VI action planning. In conclusion, II interventions were efficient to increase FVI, with or without consideration for the development of SE. Thus, future studies should favour the adoption of this approach to bridge the intention–behaviour gap for FVI.     

Can personality close the intention-behavior gap for healthy eating? An examination with the HEXACO personality traits

The aim of this study was to investigate the predictive and moderating effects of HEXACO personality factors, in addition to theory of planned behavior (TPB) variables, on fruit and vegetable consumption. American college students (N = 1036) from 24 institutions were administered the TPB, HEXACO and a self-reported fruit and vegetable consumption measure. The TPB predicted 11–17% of variance in fruit and vegetable consumption, with greater variance accounted for in healthy weight compared to overweight individuals. Personality did not significantly improve the prediction of behavior above TPB constructs; however, conscientiousness was a significant incremental predictor of intention in both healthy weight and overweight/obese groups. While support was found for the TPB as an important predictor of fruit and vegetable consumption in students, little support was found for personality factors. Such findings have implications for interventions designed to target students at risk of chronic disease.