Predictors of healthcare professionals' intention and behaviour to encourage physical activity in patients with cardiovascular risk factors

<p>Abstract</p> <p>Background</p> <p>Healthcare professionals can play a crucial role in optimizing the health status of patients with cardiovascular risk factors (abdominal obesity, high blood pressure, low HDL cholesterol, elevated triglycerides and elevated blood glucose). In order to do this, it is imperative that we understand the social-cognitive determinants (including habits) that underlie healthcare professionals' intention and the corresponding behavior of actually encouraging patients with cardiovascular risk factors to engage in physical activity.</p> <p>Methods</p> <p>In this longitudinal Professionals' Intention and Behavior (PIB) study, healthcare professionals (N = 278, aged 20-61 years with approximately 60% having attained an education level exceeding bachelor's degree, types of healthcare professionals 60% in physiotherapy and 40% in nursing) completed online surveys measuring the social-cognitive determinants of healthcare professionals' intention and the corresponding behavior of actually encouraging patients with cardiovascular risk factors to engage in physical activity.</p> <p>Results</p> <p>Social-cognitive determinants accounted for 41% (p < .001) of the variance in healthcare professionals' intention to encourage physical activity among cardiovascular patients. Important correlates of intention were attitude (β = .443, p < .001), subjective norms (β = .201, p < .001) and perceived behavioral control (β = .137, p < .01). With respect to the self-reported behavior of encouraging patients, social-cognitive determinants accounted for 29% (p < .001) of the variance. Intentions (β = .311 p < .001), habit (β = .163 p < .01), and barriers (β = -.239 p < .001) were significant correlates of professionals' behavior of encouraging patients to engage in physical activity.</p> <p>We explored the congruence between healthcare professionals' intention to encourage patients and the self-reported behavior of encouraging patients. We found that intention and behavior were congruent in 39.7% of the healthcare professionals. Additionally, the intention to encourage and the corresponding behavior of encouraging was incongruent in 31.7% of the healthcare professionals.</p> <p>Conclusions</p> <p>In the prevention of cardiovascular disease, healthcare professionals' intention to encourage physical activity among patients and subsequent behavior of encouraging patients is important for the improvement of patients' cardiovascular risk profiles. We found that the intentions and self-reported behavior of healthcare professionals working with patients with cardiovascular risk factors can be predicted by social-cognitive determinants thus implying that efforts to change and strengthen the intention-behavior relationship of healthcare professionals may have beneficial effects for cardiovascular risk patients (Trial ID: ECP-92).</p

The development of an adolescent smoking cessation intervention—an Intervention Mapping approach to planning

The objective of this project was to develop a theory- and evidence-based adolescent smoking cessation intervention using both new and existing materials. We used the Intervention Mapping framework for planning health promotion programmes. Based on a needs assessment, we identified important and changeable determinants of cessation behaviour, specified change objectives for the intervention programme, selected theoretical change methods for accomplishing intervention objectives and finally operationalized change methods into practical intervention strategies. We found that guided practice, modelling, self-monitoring, coping planning, consciousness raising, dramatic relief and decisional balance were suitable methods for adolescent smoking cessation. We selected behavioural journalism, guided practice and Motivational Interviewing as strategies in our intervention. Intervention Mapping helped us to develop as systematic adolescent smoking cessation intervention with a clear link between behavioural goals, theoretical methods, practical strategies and materials and with a strong focus on implementation and recruitment. This paper does not present evaluation data

Evaluating traffic informers: Testing the behavioral and social-cognitive effects of an adolescent bicycle safety education program

AbstractIn The Netherlands, 12–24 years old are over-represented in the total number of traffic fatalities and injuries. In this study, the traffic informer program – designed to promote safe traffic behavior in the pre-driver population – was experimentally evaluated, with a specific focus on bicycle use. Students were subjected to graphic videos of traffic accidents and listened to a first-person narrative provided by a traffic accident victim. The influence of the program on concepts derived from the theory of planned behavior and protection motivation theory (attitudes, norms, self-efficacy, risk-perception, intention and behavior) was assessed. Students from various schools (N=1593;M age=15 years, SD=.84) participated in a quasi-experimental study, either in an experimental or a control group, completing self-report questionnaires one week prior to the program implementation and approximately one month after the program implementation. Mixed regression analyses showed significant positive and negative time×intervention interaction effects on attitude toward traffic violations, relative attitude toward traffic safety, and risk comparison, but not on intention and behavior. More research is needed to find effective behavioral change techniques (other than increasing risk awareness) for promoting safe traffic behavior in adolescents. Research is also needed to address how these can be translated into effective interventions and educational programs

Public Reactions to People with HIV/AIDS in the Netherlands

A national telephone survey was conducted (1) to assess present-day public reactions to people with HIV/AIDS in the Netherlands, (2) to measure how knowledge about highly active antiretroviral therapy (HAART) is related to public reactions to people with HIV/AIDS, and (3) to investigate determinants of willingness to have personal contact with people with HIV/AIDS. Dutch adults (N = 751) participated in a telephone interview conducted to measure cognitive, emotional and behavioral reactions to people with HIV/AIDS. This study has shown that public reactions to people with HIV/AIDS seem to be moderately positive in the Netherlands. Knowledge about HAART is related to lower risk perceptions, a positive attitude towards homosexuals, less fear and more willingness to have personal contact with people with HIV/AIDS. In particular cognitive, but also emotional factors are meaningfully related to willingness to have personal contact with people with HIV/AIDS. Implications for Dutch AIDS educational campaigns aimed at stigma reduction are discussed

Changing mobility patterns and road mortality among pre-license teens in a late licensing country: an epidemiological study

Abstract Background Whereas the safety of teens in early licensing countries has been extensively studied, little is known about the safety of pre-license teens in late licensing countries, where these teens also may be at risk. This risk exists because of the combination of a) increasing use of travel modes with a high injury risk, such as bicycles and mopeds, b) inexperience, and c) teens’ developmental stage, known to be associated with risk taking and novelty seeking, especially among males. To explore the magnitude and nature of pre-license road risk, this study analysed epidemiological data from the Netherlands, and hypothesized that in this late licensing country, ‘independent travel’ and the use of riskier modes of transport increase among pre-license teens 10 to 17 years of age, resulting in higher fatality rates, with ‘experience’ and ‘gender’ as risk modifying factors. Method National travel and fatality data of pre-license adolescents in the Netherlands were analysed by traffic role (cyclist, pedestrian, car passenger and moped rider), and compared to a younger age group (0–9 years) and an older age group (18+ years). Results The study of travel data showed that teens migrate from being car occupants to being users of riskier modes of transport, specifically bicycles and mopeds. This migration resulted in a strong rise in road fatalities, illustrating the importance of mobility patterns for understanding changes in road fatalities in this age group. The data further suggested a protective role of early cycle experience for young adolescent cyclists, particularly for young males. But further study into the underlying mechanism is needed to confirm this relationship. Moped risk was extremely high, especially among young males, and even higher than that of young male car drivers. Conclusions The study confirmed the importance of changes in mobility patterns for understanding the rising road mortality when youngsters enter into their teens. The focus on fatalities has led to an underestimation of the magnitude of the problem because of the physical resilience of young adolescents that leads to high survival rates but probably also to long term disabilities. In addition, to explore the generalizability of these results, international comparisons among and between early and late licensing countries are necessary, especially in relation to moped riding as an alternative for car driving.http://deepblue.lib.umich.edu/bitstream/2027.42/112337/1/12889_2011_Article_5237.pd

Process evaluation of two environmental nutrition programmes and an educational nutrition programme conducted at supermarkets and worksite cafeterias in the Netherlands

This article describes the process evaluation of two environmental programs and a educational nutrition program, implemented at supermarkets and worksite cafeterias. Studies conducted earlier, indicated that the programs had no effect on consumers’ eating behavior. Consequently, the more specific purpose of the present study was to identify explanations for the ineffectiveness of the programs and to formulate recommendations for future programs. Materials and Methods The environmental programs included labeling of healthy products and increasing the range of healthy foods on offer. The education program consisted of several elements, such as brochures and a self-help guide. Semi-structured interviews were conducted with twenty-one managers of supermarkets and worksite cafeterias where the programs were implemented. Results Although materials were not always entirely compatible with the different supermarkets and worksite cafeterias, the degree of implementation was satisfactory. According to the managers, the programs were not striking enough, the labeling would have been more effective if it had discriminated between different brands of a product, and the number of new products was too small compared to the total range of foods on offer. Discussion The results can be used to help design and check future intervention programs for use at supermarkets or worksite cafeterias. Recommendations for future programs and research are given

When the frame fits the social picture:The effects of framed social norm messages on healthy and unhealthy food consumption

We investigated the influence of framed norm messages about food consumption on motivation to consume, and actual consumption of, healthy and unhealthy foods. We proposed that the effects of positive and negative message frames would vary by the type of underlying norms (i.e., injunctive, descriptive). More specifically, based on information processing theories, it was expected that injunctive norms would be more effective when framed negatively compared with positively, while the opposite was expected for descriptive norms. In both experiments, participants were randomly assigned to one of four framed social norm conditions or a no-norm control condition. In experiment 1, motivation to consume healthy and unhealthy foods was assessed by means of both indirect and self-report measures. In experiment 2, actual food consumption was assessed. In both experiments, the predicted interaction was found. Results show that injunctive norms benefit from a negative (vs. Positive) frame, while preliminary evidence suggests the opposite for descriptive norms