The COVID-19 Crisis as a Teachable Moment for Lifestyle Change in Dutch Cardiovascular Disease Patients

Objective: When lifestyle changes are needed, life events or crises such as COVID-19 may function as “teachable moments”. This study aimed to explore whether the pandemic can provoke a teachable moment regarding lifestyle change in cardiovascular disease patients.Method: In this cross-sectional survey study, 830 cardiovascular disease patients reported their intentions to change lifestyle, instigated by the corona crisis, together with risk perception, affective impact, and changed self-concept, based on a “teachable moments” framework.Results: Between 8 and 28% of the sample reported increased intentions to optimize lifestyle behaviors, particularly related to general lifestyle (28%), physical activity (25%), and diet (21%). Multivariate regression analyses revealed that changed self-concept was associated with higher intentions to improve general lifestyle (B = 0.26; CI = 0.19–0.33), physical activity (B = 0.23; CI = 0.16–0.30), and smoking (B = 0.29; CI = 0.01–0.57). In addition, changed self-concept and affective impact were both significantly associated with higher intentions to improve diet (resp. B = 0.29; CI = 0.21–0.36 and B = 0.12; CI = 0.04–0.21) and to limit alcohol consumption (resp. B = 0.22; CI = 0.13–0.30 and B = 0.11; CI = 0.01–0.20). We did not find evidence for an important role of risk perception on behavior change intentions.Conclusion: The COVID-19 crisis evoked a potential teachable moment for lifestyle change in cardiovascular disease patients, driven by a change in a patient's self-concept and to a lesser extent by an affective impact of the COVID-19 crisis. These results suggest an important window of opportunity for healthcare professionals to utilize the pandemic to promote a healthy lifestyle to their patients

Measuring determinants of implementation behavior: psychometric properties of a questionnaire based on the theoretical domains framework

BACKGROUND: To be able to design effective strategies to improve healthcare professionals’ implementation behaviors, a valid and reliable questionnaire is needed to assess potential implementation determinants. The present study describes the development of the Determinants of Implementation Behavior Questionnaire (DIBQ) and investigates the reliability and validity of this Theoretical Domains Framework (TDF)-based questionnaire. METHODS: The DIBQ was developed to measure the potential behavioral determinants of the 12-domain version of the TDF (Michie et al., 2005). We identified existing questionnaires including items assessing constructs within TDF domains and developed new items where needed. Confirmatory factor analysis was used to examine whether the predefined structure of the TDF-based questionnaire was supported by the data. Cronbach’s alpha was calculated to assess internal consistency reliability of the questionnaire, and domains’ discriminant validity was investigated. RESULTS: We developed an initial questionnaire containing 100 items assessing 12 domains. Results obtained from confirmatory factor analysis and Cronbach’s alpha resulted in the final questionnaire consisting of 93 items assessing 18 domains, explaining 63.3% of the variance, and internal consistency reliability values ranging from .68 to .93. Domains demonstrated good discriminant validity, although the domains ‘Knowledge’ and ‘Skills’ and the domains ‘Skills’ and ‘Social/professional role and identity’ were highly correlated. CONCLUSIONS: We have developed a valid and reliable questionnaire that can be used to assess potential determinants of healthcare professional implementation behavior following the theoretical domains of the TDF. The DIBQ can be used by researchers and practitioners who are interested in identifying determinants of implementation behaviors in order to be able to develop effective strategies to improve healthcare professionals’ implementation behaviors. Furthermore, the findings provide a novel validation of the TDF and indicate that the domain ‘Environmental context and resources’ might be divided into several environment-related domains

With a little help from my goals : integrating intergoal facilitation with the theory of planned behaviour to predict physical activity

Reproduced with permission from British Journal of Health Psychology © The British Psychological Society 2010.Peer reviewedPostprin

Acceptance, well-being, and goals in adolescents with chronic illness : a daily process analysis

Objective: The main aim of this study was to investigate the relationship between acceptance and well-being in adolescents with chronic illness from a daily process perspective. Furthermore, we explored the role of daily experienced interference and facilitation of life goals by treatment goals as mediating mechanisms. Methods: Thirty-eight adolescents with cystic fibrosis (CF) or diabetes completed questionnaires assessing acceptance, negative life events and goal-related self-efficacy. Furthermore, an online diary assessing daily mood, daily experienced interference and facilitation of life goals by treatment goals was completed during three consecutive weeks. Results: Acceptance of illness was positively related to daily well-being, but unrelated to daily goal interference and facilitation. Furthermore, daily goal interference and facilitation were unrelated to same-day and next-day well-being. Conclusion: This study suggests that acceptance of illness plays an important role in the daily mood of adolescents with CF and diabetes. This relationship, however, was not mediated by daily experienced interference and facilitation of life goals by treatment goals. Further research is needed to determine whether interventions promoting acceptance are beneficial for adolescents with CF and diabetes

Self-generated goals and goal process appraisals: Relationships with sociodemographic factors and well-being

In this study the full array of personal goals pursued by adolescents was examined using an idiographic goal-elicitation procedure. The aims of the study were twofold. Firstly, we investigated individual differences in self-generated goals and goal process appraisals based on sociodemographic characteristics. Secondly, we investigated the relationship between goal content, goal process appraisals and well-being. Questionnaires were completed by 438 high-school students aged 12 to 19. Girls reported more school, relationship, self and body goals and older students reported more future trajectory goals. In addition, girls and ethnic minority adolescents were more likely to report goal frustration. Well-being was positively associated with goal related self-efficacy and negatively associated with endorsement of self goals, perceived difficulty in goal attainment and goal frustration. These results extend previous findings and suggest that goal-related efficacy, attainment beliefs and impediment to goal pursuit are important factors in adolescent well-being

Adolescent goal content and pursuit: A review of the literature from the past 16 years

The aim of this article is to provide an overview and discussion of the literature from various areas of psychology on adolescent goal content and pursuit since the publication of Nurmi's review in 1991. Ninety-four studies were identified which incorporated a measure of adolescent goal content/processes. We explore and discuss the theories employed in these studies, methods of goal measurement, and the findings presented in the studies. Adolescent goal content and pursuit appear to be influenced by various sociodemographic and psychological factors. In turn, goal content, goal pursuit and (un)successful goal attainment are related to adolescent behavior, health and well-being. Limitations and suggestions for further research are discussed

Goal frustration, coping and well-being in the context of adolescent headache: A self-regulation approach

The aim of this study was to investigate the relationships between goal frustration, coping and well-being in the context of adolescent headache. Firstly, we investigated whether adolescents with weekly, monthly or no headache complaints differed with regard to the importance assigned to their personal goals, experience of goal frustration, coping with goal frustration and well-being. Secondly, the extent to which goal and coping factors contributed to well-being and whether this relationship differed according to the frequency of headache complaints was examined. For this purpose, 1202 adolescents aged 12-18 completed self-report questionnaires in schools. Adolescents were divided into three groups based on their experience of headache: no headache reported (38%); monthly headache (40%); weekly headache (18%). Results show that these groups did not differ with respect to the importance they attach to goals. They did, however, differ according to experience of goal frustration, use of strategies to cope with goal frustration and well-being, although effect sizes were small. After controlling for individual and headache characteristics, frustration of self acceptance and health goals, and the use of self blame, rumination and other blame were consistently related to lower well-being. Moreover, interactions with headache group indicated that for adolescents with weekly headache, greater frustration of school and self acceptance goals and a lower importance assigned to health goals was more detrimental to well-being than for those with no headache complaints. We conclude that frustration to goal pursuit and strategies for coping with this frustration are important factors in adolescent well-being and may offer important targets for intervention

Mixed feelings: Ambivalence as a predictor of relapse in ex-smokers

Objectives. Ambivalence can be viewed as a normal temporary psychological state in a decision process, for example, on quitting smoking. However, when ambivalence is still present after the decision has been made, it may undermine the motivation to stick to the decision. In smoking cessation, ambivalence can be expected to increase the risk for relapse. Design. In a cohort of 352 ex-smokers, felt ambivalence measured at baseline was used to predict relapse after I month. Results. Firstly, felt ambivalence was a predictor of relapse. Secondly, felt ambivalence moderated the strength of the relation between a psychological determinant of behaviour and actual behaviour: anticipated negative self-evaluative emotions only predicted relapse when felt ambivalence was low. Thirdly, the relation of felt ambivalence with relapse was partly mediated by ex-smokers' evaluations of risk situations (situations in which they used to smoke in the past). Conclusion. Ambivalence is related to relapse in different ways and in ex-smokers it may be conceptualized as a non-optimal decision process. Although the role of felt ambivalence needs further study, the data suggest that ambivalence must be taken into account in the practice of relapse prevention

'I'm better off now':The role of temporal comparisons and exposure evaluations in smoking cessation

Two new psychological concepts related to relapse in smoking cessation were tested. 'Temporal comparisons' are ex-smokers' evaluations of their present situation compared to their situation as a smoker. 'Exposure evaluations' are evaluations of situations ex-smokers encountered when they used to smoke. In a cohort study among 323 ex-smokers, both concepts significantly predicted relapse after six months. Moreover, the relationship between temporal comparisons and relapse was mediated by exposure evaluations. In addition, this relationship also depended on self-efficacy; particularly when self-efficacy was low, temporal comparisons predicted relapse. These data provide new theoretical and practical perspectives to relapse