Do interventions containing risk messages increase risk appraisal and the subsequent vaccination intentions and uptake?:A systematic review and meta-analysis

Purpose There is good evidence that for many behaviours, increasing risk appraisal can lead to a change in behaviour, heightened when efficacy appraisals are also increased. The present systematic review addressed whether interventions presenting a risk message increase risk appraisal and an increase in vaccination intentions and uptake. Method A systematic search identified randomized controlled trials of interventions presenting a risk message and measuring risk appraisal and intentions and uptake post-intervention. Random-effects meta-analyses investigated the size of the effect that interventions had on vaccination risk appraisal and on vaccination behaviour or intention to vaccinate, and the size of the relationship between vaccination risk appraisal and vaccination intentions and uptake. Results Eighteen studies were included and 16 meta-analysed. Interventions overall had small significant effects on risk appraisal (d = 0.161, p = .047) and perceptions of susceptibility (d = 0.195, p = .025), but no effect on perceptions of severity (d = −0.036, p = .828). Interventions showed no effect on intention to vaccinate (d = 0.138, p = .195) and no effect on vaccination behaviour (d = 0.043, p = .826). Interventions typically did not include many behaviour change techniques (BCTs), with the most common BCT unique to intervention conditions being ‘Information about Health Consequences’. Few of the included studies attempted to, or successfully increased, efficacy appraisals. Conclusions Overall, there is a lack of good-quality primary studies, and existing interventions are suboptimal. The inclusion of additional BCTs, including those to target efficacy appraisals, could increase intervention effectiveness. The protocol (CRD42015029365) is available from http://www.crd.york.ac.uk/PROSPERO/

Intervention to reduce adolescent hookah pipe use and satisfy basic psychological needs

Background: Hookah pipe use is a public health concern and threat to adolescents’ health. self-determination theory asserts that satisfaction of basic psychological needs (BPN) will contribute to adolescents developing optimally. Purpose: The purpose of this study was to design an intervention to reduce adolescent hookah pipe use and satisfy their BPN. Methods: A modified delphi approach was implemented using a two-phased approach. Phase 1 included reviews and empirical research that formed part of the needs analysis. Phase 2 was the development of the intervention in collaboration with stakeholders from academia, policy and practice (n = 25). The stakeholders formed the sample for this study. Phase 1 informed phase 2. Phase 2 was implemented through a 4-hour workshop with the stakeholders. The workshop was audio recorded, transcribed verbatim and thematically analysed. Principal Results: The results indicated that a holistic four-pronged approach focusing on (1) the hookah pipe user, (2) the family, (3) after school recreation activities and (4) the teacher and community was needed as a model to intervene in adolescent hookah pipe use and satisfy their BPN. The intervention was described using the RE-AIM framework which considers reach, efficacy, adoption, implementation and maintenance of the intervention

Pragmatic nihilism: how a Theory of Nothing can help health psychology progress

Health psychology developed a plethora of theories to explain and change a wide variety of behaviours. Several attempts have been undertaken to build integrative theories, some even striving for a Theory of Everything. We argue against these efforts, arguing that instead a 'pragmatic nihilism' perspective may be more fruitful to understand and change health behaviours. The first tenet of pragmatic nihilism is that psychological variables are usefully considered as metaphors rather than referring to entities that exist in the mind. As a consequence, the second tenet emphasizes theories' definitions and guidelines for the operationalisation of those variables. The third tenet of pragmatic nihilism is that each operationalisation represents an intersection of a variety of dimensions, such as behavioural specificity and duration, and most importantly, psychological aggregation level. Any operationalisation thus represents a number of choices regarding these dimensions. Pragmatic nihilism has two implications. First, it provides a foundation that enables integrating theories in a more flexible and accurate manner than made possible by integrative theories. Second, it emphasizes the importance of operationalisations, underlining the importance of investing in the careful development of measurement instruments, thorough reporting of measurement instruments' specifics and performance, and full disclosure of the instruments themselves