Communication of a mental health diagnosis: a systematic synthesis and narrative review

Background: There is limited understanding of the mechanisms used to effectively communicate with service-users about their mental health diagnoses. Aims: To conduct a systematic synthesis of studies that present data on the communication of a psychiatric diagnosis. Methods: Comprehensive database and manual searches were conducted resulting in the inclusion of 30 quantitative and qualitative papers. Results: The majority of studies were descriptive. The rate of service-users being informed of their diagnosis has increased over the past decade. Consumer communication preferences were not always satisfactorily addressed in practice. Individual characteristics of service-users and clinicians influenced whether a diagnostic discussion took place. Results from intervention studies aimed at facilitating diagnostic communication reported significant improvements in service-user satisfaction and mood and clinician communication skills. Conclusions: This review highlights a gap in the system of communication between clinicians and service-users. To assist clinicians to talk effectively with individuals about their mental health, communication protocols and training need to be further developed and assessed. Such developments would benefit from well-designed randomised controlled trial protocols, should incorporate service-users’ preferences and address stigma-related concerns

Diagnosis telling in people with psychosis

Purpose of review: There are complexities in communicating diagnostic information relating to schizophrenia spectrum disorders. There is a current dearth of research in understanding how clinicians effectively communicate with service users about such diagnostic news. In this review, we aim to synthesize the latest research throughout 2012 and 2013 that presented data relating to the communication of a diagnosis of schizophrenia spectrum disorders, including individuals who had experienced first-episode psychosis or were in at-risk mental states. Comprehensive database and manual searches were conducted which obtained data from both service users and health professional groups. Recent findings: Fourteen quantitative and qualitative studies were found. The majority of studies were descriptive and heterogeneous in content. Key themes included service user preferences towards disclosure and diagnostic terminology, health professional training, stigma-related issues and the use of diagnostic communication models. Summary: Overall, communication models that foster therapeutic relationships and actively encourage the health professional to reduce stigma may be a key to initial diagnostic discussions in clinical practice. Such communication models and intervention require further more rigorous evaluation, as none have been tested through randomized controlled protocols in clinical settings

An application of the theory of planned behavior - A randomized controlled food safety pilot intervention for young adults

Objective: Approximately 48 million Americans are affected by foodborne illness each year. Evidence suggests that the application of health psychology theory to food safety interventions can increase behaviors that reduce the incidence of illness such as adequately keeping hands, surfaces and equipment clean. This aim of this pilot study was to be the first to explore the effectiveness of a food safety intervention based on the Theory of Planned Behavior (TPB). Methods: Young adult participants (N = 45) were randomly allocated to intervention, general control or mere measurement control conditions. Food safety observations and TPB measures were taken at baseline and at 4-week follow-up. Within and between group differences on target variables were considered and regression analyses were conducted to determine the relationship between condition, behavior and the TPB intention constructs; attitude, subjective norm, perceived behavioral control (PBC). Results: TPB variables at baseline predicted observed food safety behaviors. At follow-up, the intervention led to significant increases in PBC (p = .024) and observed behaviors (p = .001) compared to both control conditions. Furthermore, correlations were found between observed and self-reported behaviors (p = .008). Conclusions: The pilot intervention supports the utility of the TPB as a method of improving food safety behavior. Changes in TPB cognitions appear to be best translated to behavior via behavioral intentions and PBC. Further research should be conducted to increase effectiveness of translating TPB variables to food safety behaviors. The additional finding of a correlation between self-reported and observed behavior also has implications for future research as it provides evidence toward the construct validity of self-reported behavioral measures

Smokers and ex-smokers reaction to anti-smoking advertising : a mixed methods approach

Anti-smoking advertising is a central component of modern public health policy. Nevertheless, some smokers have reported that viewing anti-smoking advertising provokes intense nicotine craving. Anti-smoking advertising frequently features images of cigarettes and of individuals smoking. However, research indicates that images of tobacco paraphernalia may induce cravings in individuals addicted to nicotine. The effects of the presence of smoking cues in anti-smoking advertising were considered in the present study. Smokers and ex-smokers (N=63) were randomly assigned to view an anti-smoking advertisement or to complete a control task. Urge to smoke was measured pre- and post-test. Qualitative responses to anti-smoking advertising were also elicited from all participants in the intervention groups. According to both qualitative and quantitative data analyses viewing anti-smoking advertising, even with images of smoking related paraphernalia, led to decreases in craving amongst smokers. Ex-smokers experienced no change in quantitatively measured craving after viewing anti-smoking advertising. These findings are inconsistent with findings from studies using neutral or positive smoking cues. Qualitative data shows that no smokers or ex-smokers who viewed anti-smoking advertising reported an increase in tobacco craving as a result of viewing the campaign. Implications of these findings for future research and anti-smoking campaigns are discussed

The Effect of Non-specific Response Inhibition Training on Alcohol Consumption: An Intervention

Objective: Excessive alcohol consumption increases the risk of alcohol-related disease and injury. Poor response inhibition; the inability to intentionally override a pre-potent response, has been associated with greater alcohol consumption. The aim of the present study was to clarify if non-specific response inhibition training could improve response inhibition, and reduce alcohol consumption. Method: One hundred and sixty-eight undergraduates were randomly assigned to either an inhibition or active control condition, and completed a stop-signal task once a day for four consecutive days. The inhibition condition comprised a stop-signal task with a high target density (50% stop-signals), while the active control comprised a stop-signal task with a lower target density (25% stop-signals) and the instruction to ignore the signal. Before and after the intervention, participants completed measures of response inhibition, and alcohol consumption. Alcohol consumption was measured again at one month post-training. All parts of the study were completed online. Results: Contrary to the hypotheses, participants in the inhibition condition did not have lower levels of alcohol consumption, nor improved response inhibition after the intervention, compared to participants in the active control condition. Conclusion: It is suggested that response inhibition training needs to be specific to the target behaviour in order to be effective; however, that training did not improve response inhibition itself, calls into question the efficacy of this particular training paradigm. It is recommended that future response inhibition training paradigms consider how training intensity, and the format of administration, influences behavioural outcomes

Active behaviour change safety interventions in the construction industry: A systematic review

© 2015 Elsevier Ltd. The aims of this paper were to systematically review the evidence for the effectiveness of active behaviour change safety interventions in the construction industry; and to determine the intervention characteristics most commonly associated with effectiveness in reducing injury rates and improving safety behaviour - intensity/frequency/duration, behaviour change techniques (BCTs) and theory-base. An electronic literature search (June 2014) was conducted to identify eligible interventions: those involving active involvement from workers/management in the construction industry; targeted one/both of the primary outcomes. All intervention designs involving construction workers aged >18 years, published in English and in a peer-reviewed journal were included. Fifteen studies were included, half of which successfully improved injury rates. Longer interventions and those that included active/volitional BCTs (feedback/monitoring rather than instruction/information) were more effective. The methodological quality of the interventions was poor and use of theory was inconsistent and infrequent. Despite some positive results, very few interventions achieved all their aims. More rigorous, theory-driven research is needed to structure intervention efforts and determine the mechanism of action of effective interventions

The US Distribution of Physicians from Lower Income Countries

Introduction: Since the 1960 s, the number of international medical graduates (IMGs) in the United States has increased significantly. Given concerns regarding the effects of this loss to their countries of origin, the authors undertook a study of IMGs from lower income countries currently practicing in the United States. Methods: The AMA Physician Masterfile was accessed to identify all 265,851 IMGs in active practice in the United States. These were divided by state of practice and country of origin. World Bank income classification was used to identify lowe

The role of self-regulation in predicting sleep hygiene in university students

University students have poor sleep hygiene, leading to poorer health. Facets of self-regulation such as planning, behavioural inhibition, cognitive flexibility and working memory were explored in relation to three sleep hygiene behaviours: Avoiding stress or anxiety before bed, avoiding going to bed hungry or thirsty, and making the bedroom restful. One hundred and thirty-seven participants took part in an Internet-based survey over two time points separated by a period of two weeks. Only cognitive flexibility and behavioural inhibition correlated with sleep hygiene. Cognitive flexibility significantly predicted an aspect of sleep hygiene after controlling for past behaviour. However, when past behaviour was controlled for, behavioural inhibition no longer predicted sleep hygiene. Thus, cognitive flexibility may play a role in explaining sleep hygiene; however, behavioural inhibition does not appear as important as previously assumed. Further research could build on this study to determine whether cognitive flexibility can be experimentally improved

Determining motivation to engage in safe food handling behaviour

Purpose: To apply the protection motivation theory to safe food handling in order to determine the efficacy of this model for four food handling behaviours: cooking food properly, reducing cross-contamination, keeping food at the correct temperature and avoiding unsafe foods. Design: A cross-sectional approach was taken where all protection motivation variables: perceived severity, perceived vulnerability, self-efficacy, response efficacy, and protection motivation, were measured at a single time point. Findings: Data from 206 participants revealed that the model accounted for between 40 and 48% of the variance in motivation to perform each of the four safe food handling behaviours. The relationship between self-efficacy and protection motivation was revealed to be the most consistent across the four behaviours. Implications: While a good predictor of motivation, it is suggested that protection motivation theory is not superior to other previously applied models, and perhaps a model that focuses on self-efficacy would offer the most parsimonious explanation of safe food handling behaviour, and indicate the most effective targets for behaviour change interventions. Originality: This is the first study to apply and determine the efficacy of protection motivation theory in the context of food safety

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