Mood as a resource in dealing with health recommendations: How mood affects information processing and acceptance of quit-smoking messages

Objective: An experimental study tested the effects of positive and negative mood on the processing and acceptance of health recommendations about smoking in an online experiment. It was hypothesised that positive mood would provide smokers with the resources to systematically process self-relevant health recommendations.Design: One hundred and twenty-seven participants (smokers and non-smokers) read a message in which a quit smoking programme was recommended. Participants were randomly assigned to one of four conditions: positive versus negative mood, and strong versus weak arguments for the recommended action.Main outcome measures: Systematic message processing was inferred when participants were able to distinguish between high- and low-quality arguments, and by congruence between attitudes and behavioural intentions. Persuasion was measured by participant's attitudes towards smoking and the recommended action, and by their intentions to follow the action recommendation.Results: As predicted, smokers systematically processed the health message only under positive mood conditions; non-smokers systematically processed the health message only under negative mood conditions. Moreover, smokers’ attitudes towards the health message predicted intentions to quit smoking only under positive mood conditions.Conclusion: Findings suggest that positive mood may decrease defensive processing of self-relevant health information

Overweight at age two years in a multi-ethnic cohort (ABCD study): the role of prenatal factors, birth outcomes and postnatal factors

<p>Abstract</p> <p>Background</p> <p>Childhood overweight/obesity is a major public health problem worldwide which disproportionally affects specific ethnic groups. Little is known about whether such differences already exist at an early age and which factors contribute to these ethnic differences. Therefore, the present study assessed possible ethnic differences in overweight at age 2 years, and the potential explanatory role of prenatal factors, birth outcomes and postnatal factors.</p> <p>Methods</p> <p>Data were derived from a multi-ethnic cohort in the Netherlands (the ABCD study). Weight and height data of 3,156 singleton infants at age 2 years were used. Five ethnic populations were distinguished: Dutch native (n = 1,718), African descent (n = 238), Turkish (n = 162), Moroccan (n = 245) and other non-Dutch (n = 793). Overweight status was defined by the International Obesity Task Force guidelines. The explanatory role of prenatal factors, birth outcomes and postnatal factors in ethnic disparities in overweight (including obesity) was assessed by logistic regression analysis.</p> <p>Results</p> <p>Compared to the native Dutch (7.1%), prevalence of overweight was higher in the Turkish (19.8%) and Moroccan (16.7%) group, whereas the prevalence was not increased in the African descent (9.2%) and other non-Dutch (8.8%) group. Although maternal pre-pregnancy body mass index partly explained the ethnic differences, the odds ratio (OR) of being overweight remained higher in the Turkish (OR: 2.66; 95%CI: 1.56-4.53) and Moroccan (OR: 2.11; 95%CI: 1.31-3.38) groups after adjusting for prenatal factors. The remaining differences were largely accounted for by weight gain during the first 6 months of life (postnatal factor). Maternal height, birth weight and gender were independent predictors for overweight at age 2 years, but did not explain the ethnic differences.</p> <p>Conclusion</p> <p>Turkish and Moroccan children in the Netherlands have 2- to 3-fold higher odds for being overweight at age 2 years, which is largely attributed to maternal pre-pregnancy BMI and weight gain during the first 6 months of life. Further study on the underlying factors of this early weight gain is required to tackle ethnic differences in overweight among these children.</p

Improving patient adherence to lifestyle advice (IMPALA): a cluster-randomised controlled trial on the implementation of a nurse-led intervention for cardiovascular risk management in primary care (protocol)

Background Many patients at high risk of cardiovascular diseases are managed and monitored in general practice. Recommendations for cardiovascular risk management, including lifestyle change, are clearly described in the Dutch national guideline. Although lifestyle interventions, such as advice on diet, physical exercise, smoking and alcohol, have moderate, but potentially relevant effects in these patients, adherence to lifestyle advice in general practice is not optimal. The IMPALA study intends to improve adherence to lifestyle advice by involving patients in decision making on cardiovascular prevention by nurse-led clinics. The aim of this paper is to describe the design and methods of a study to evaluate an intervention aimed at involving patients in cardiovascular risk management. Methods A cluster-randomised controlled trial in 20 general practices, 10 practices in the intervention arm and 10 in the control arm, starting on October 2005. A total of 720 patients without existing cardiovascular diseases but eligible for cardiovascular risk assessment will be recruited. In both arms, the general practitioners and nurses will be trained to apply the national guideline for cardiovascular risk management. Nurses in the intervention arm will receive an extended training in risk assessment, risk communication, the use of a decision aid and adapted motivational interviewing. This communication technique will be used to support the shared decision-making process about risk reduction. The intervention comprises 2 consultations and 1 follow-up telephone call. The nurses in the control arm will give usual care after the risk estimation, according to the national guideline. Primary outcome measures are self-reported adherence to lifestyle advice and drug treatment. Secondary outcome measures are the patients' perception of risk and their motivation to change their behaviour. The measurements will take place at baseline and after 12 and 52 weeks. Clinical endpoints will not be measured, but the absolute 10-year risk of cardiovascular events will be estimated for each patient from medical records at baseline and after 1 year. Discussion The combined use of risk communication, a decision aid and motivational interviewing to enhance patient involvement in decision making is an innovative aspect of the intervention. Trial registration Current Controlled Trials ISRCTN5155672

Cardiovascular diseases in non-Western immigrants in the Netherlands. An exploratory study into lifestyle, risk factors, morbidity and mortality

De Nederlandse Hartstichting is voornemens haar beleid t.a.v. preventie van hart- en vaatziekten (HVZ) mede op de doelgroep niet-westerse allochtonen te gaan richten. Om te beslissen welke (sub)groep allochtonen en welke leefstijl- of risicofactoren de hoogste prioriteit hebben binnen dit beleid, is het belangrijk om in kaart te brengen hoe deze factoren verdeeld zijn over de diverse groepen allochtonen. Ook informatie over ziekte, zorggebruik en sterfte in relatie tot HVZ geeft aanwijzingen binnen welke groep het risico op HVZ het grootst is. Binnen de leefstijl- en risicofactoren van HVZ lijken voedingsgewoonten (meer fruit, groenten en minder verzadigde vetten) en het voorkomen van hypercholesterolemie gunstig af te steken ten opzichte van de autochtone bevolking. Sommige factoren lijken meer voor te komen bij vooral oudere allochtonen: overgewicht, lichamelijke inactiviteit, hypertensie en diabetes mellitus. Het rookgedrag bij allochtonen is zeer sterk geslachtsgebonden: Turkse mannen roken beduidend meer, terwijl bijvoorbeeld Marokkaanse vrouwen niet roken. Turken, Marokkanen en Surinamers maken vaker gebruik van huisartsenzorg dan autochtone Nederlanders. Ongeveer evenveel allochtonen als autochtonen hebben jaarlijks contact met de specialist of worden jaarlijks opgenomen in het ziekenhuis. Turken hebben meer klachten, raadplegen vaker de specialist en worden vaker opgenomen in het ziekenhuis in verband met hartklachten. HVZ en ook het medicijngebruik gerelateerd aan HVZ is bij Turken lager. Marokkanen hebben minder klachten en diagnosen met betrekking tot hart - en vaatziekten. Surinamers hebben vaker klachten, er wordt vaker de diagnose 'HVZ' gesteld. Over sterfte aan HVZ bij allochtonen is een onderzoek bekend. Dit onderzoek is van oudere datum en de aantallen waarop de resultaten gebaseerd zijn, zijn klein. Bij de interpretatie van de resultaten is enige voorzichtigheid geboden, omdat in de meeste onderzoeken waaruit de resultaten afkomstig zijn het aantal geincludeerde personen klein was, en / of de dataverzameling op basis van zelfrapportage heeft plaatsgevonden en / of het onderzoek relatief oud was.The Netherlands Heart Foundation is planning to formulate a policy with respect to the prevention of cardiovascular diseases in non-Western immigrants. To decide which subgroup and which lifestyle and risk factors have the highest priority, it is important to accumulate information on the extent of these factors in the different ethnic groups. Information on illness, use of health care, morbidity and mortality in relation to cardiovascular diseases can also give an indication of which subgroup is confronted with the greatest burden of cardiovascular diseases. Of the cardiovascular lifestyle factors and risk factors, nutritional behaviour (more fruit, more vegetables and less saturated fatty acids) and the prevalence of hypercholesterolemia showed a more favourable profile in immigrants than in the native Dutch population. Overweight, physical activity, hypertension and diabetes mellitus seem to be more prevalent in non-Western immigrants, particularly in older people. Smoking habits in immigrants are strongly gender-linked: Turkish men smoke considerably more, while, for example, Moroccan women, in general, don't smoke. Turkish, Moroccan and Surinam immigrants use primary health care more than Dutch people and more frequently. The use of secondary health care (contacts with specialists) is similar and no differences were observed between immigrants and native Dutch with regard to hospitalisation. Turkish people report more symptoms, consult a specialist and are hospitalised more often for CHD problems. On the other hand, it seems that the diagnosis of CHD and the use of pharmaceuticals for CHD occur less among Turkish people. Moroccans have fewer CHD symptoms and get fewer diagnoses. The Surinam people experience more CHD symptoms and are more often diagnosed with CHD. There is only one study known (not so recent and using quite small numbers) on CHD mortality in immigrants. Some caution is required when interpreting the results in view of one or more of the following remarks. The numbers participating in the studies were usually small, most of the results were based on self-reported data and not all of the studies were recent.Nederlandse Hartstichtin

Cardiovascular diseases in non-Western immigrants in the Netherlands. An exploratory study into lifestyle, risk factors, morbidity and mortality

The Netherlands Heart Foundation is planning to formulate a policy with respect to the prevention of cardiovascular diseases in non-Western immigrants. To decide which subgroup and which lifestyle and risk factors have the highest priority, it is important to accumulate information on the extent of these factors in the different ethnic groups. Information on illness, use of health care, morbidity and mortality in relation to cardiovascular diseases can also give an indication of which subgroup is confronted with the greatest burden of cardiovascular diseases. Of the cardiovascular lifestyle factors and risk factors, nutritional behaviour (more fruit, more vegetables and less saturated fatty acids) and the prevalence of hypercholesterolemia showed a more favourable profile in immigrants than in the native Dutch population. Overweight, physical activity, hypertension and diabetes mellitus seem to be more prevalent in non-Western immigrants, particularly in older people. Smoking habits in immigrants are strongly gender-linked: Turkish men smoke considerably more, while, for example, Moroccan women, in general, don't smoke. Turkish, Moroccan and Surinam immigrants use primary health care more than Dutch people and more frequently. The use of secondary health care (contacts with specialists) is similar and no differences were observed between immigrants and native Dutch with regard to hospitalisation. Turkish people report more symptoms, consult a specialist and are hospitalised more often for CHD problems. On the other hand, it seems that the diagnosis of CHD and the use of pharmaceuticals for CHD occur less among Turkish people. Moroccans have fewer CHD symptoms and get fewer diagnoses. The Surinam people experience more CHD symptoms and are more often diagnosed with CHD. There is only one study known (not so recent and using quite small numbers) on CHD mortality in immigrants. Some caution is required when interpreting the results in view of one or more of the following remarks. The numbers participating in the studies were usually small, most of the results were based on self-reported data and not all of the studies were recent.De Nederlandse Hartstichting is voornemens haar beleid t.a.v. preventie van hart- en vaatziekten (HVZ) mede op de doelgroep niet-westerse allochtonen te gaan richten. Om te beslissen welke (sub)groep allochtonen en welke leefstijl- of risicofactoren de hoogste prioriteit hebben binnen dit beleid, is het belangrijk om in kaart te brengen hoe deze factoren verdeeld zijn over de diverse groepen allochtonen. Ook informatie over ziekte, zorggebruik en sterfte in relatie tot HVZ geeft aanwijzingen binnen welke groep het risico op HVZ het grootst is. Binnen de leefstijl- en risicofactoren van HVZ lijken voedingsgewoonten (meer fruit, groenten en minder verzadigde vetten) en het voorkomen van hypercholesterolemie gunstig af te steken ten opzichte van de autochtone bevolking. Sommige factoren lijken meer voor te komen bij vooral oudere allochtonen: overgewicht, lichamelijke inactiviteit, hypertensie en diabetes mellitus. Het rookgedrag bij allochtonen is zeer sterk geslachtsgebonden: Turkse mannen roken beduidend meer, terwijl bijvoorbeeld Marokkaanse vrouwen niet roken. Turken, Marokkanen en Surinamers maken vaker gebruik van huisartsenzorg dan autochtone Nederlanders. Ongeveer evenveel allochtonen als autochtonen hebben jaarlijks contact met de specialist of worden jaarlijks opgenomen in het ziekenhuis. Turken hebben meer klachten, raadplegen vaker de specialist en worden vaker opgenomen in het ziekenhuis in verband met hartklachten. HVZ en ook het medicijngebruik gerelateerd aan HVZ is bij Turken lager. Marokkanen hebben minder klachten en diagnosen met betrekking tot hart - en vaatziekten. Surinamers hebben vaker klachten, er wordt vaker de diagnose 'HVZ' gesteld. Over sterfte aan HVZ bij allochtonen is een onderzoek bekend. Dit onderzoek is van oudere datum en de aantallen waarop de resultaten gebaseerd zijn, zijn klein. Bij de interpretatie van de resultaten is enige voorzichtigheid geboden, omdat in de meeste onderzoeken waaruit de resultaten afkomstig zijn het aantal geincludeerde personen klein was, en / of de dataverzameling op basis van zelfrapportage heeft plaatsgevonden en / of het onderzoek relatief oud was