Poster: Getting healthcare staff more active: the mediating role of self-efficacy

Objectives. Physical activity has been associated with positive health outcomes. The objective of the study was to investigate the relationship between knowledge of physical activity, social support, self‐efficacy, perceived barriers to physical activity, and level of physical activity among healthcare employees and students in a National Health Service (NHS) Trust.Design. This study was secondary analysis of questionnaire data on the health and well‐being of staff and students within the NHS.Method. A total of 325 student nurses and 1,452 NHS employees completed the questionnaire. The data were analysed using descriptive statistics, zero‐order correlations, and structural equation modelling.Results. Self‐efficacy fully mediated the relationship between social support, perceived barriers, and level of physical activity in the student sample and partially mediated the relationship between social support, perceived barriers, and level of physical activity in the healthcare staff sample. Knowledge of physical activity had no significant effect on physical activity.Conclusion. Findings suggest that instead of instilling knowledge, interventions to promote physical activity among healthcare staff and students should enhance social support and self‐efficacy and also to remove perceived barriers to physical activity

How effective are physical activity interventions for alleviating depressive symptoms in older people?: a systematic review

Background: The benefits of physical exercise in reducing clinically defined depression in the general population have been established, although a review of the evidence for older adults is needed.Objectives: To assess the efficacy of physical exercise for the treatment of depressive symptoms in older adults (>60 years).Data sources: We searched: MEDLINE (1966—May 2008); EMBASE (1980—May 2008); Cumulative Index to Nursing & Allied Health Literature (CINAHL; 1982—May 2008); PsycINFO (1966—May 2008), The Cochrane Library (Issue 2, 2008), and National Research Register (NRR; Issue 2, 2008).Review methods: Randomized controlled trials and quasi-experimental studies of physical exercise interventions for depression were included where 80% or more of participants were >60 years. Abstracts were assessed to determine whether they met specified inclusion criteria. Primary analysis focused on the prevalence of diagnosable depressive disorder following intervention. Secondary outcome was depression or mood scores on standardized scales.Results: Eleven randomized controlled trials with a total of 641 participants were included in the review. Short-term positive outcome for depression or depressive symptoms was found in nine studies, although the mode, intensity and duration of intervention varied across studies. Medium- to long-term effects of intervention were less clear.Conclusion: Physical exercise programmes obtain clinically relevant outcomes in the treatment of depressive symptoms in depressed older people. Exercise, though not appropriate for all in this population, may improve mood in this group. Further research is needed to establish medium- to long-term effects and cost-effectiveness

The prevalence and factors for cancer screening behavior among people with severe mental illness in Hong Kong

Objectives: Screening is useful in reducing cancer incidence and mortality. People with severe mental illness (PSMI) are vulnerable to cancer as they are exposed to higher levels of cancer risks. Little is known about PSMI's cancer screening behavior and associated factors. The present study examined the utilization of breast, cervical, prostate, and colorectal cancer screening among PSMI in Hong Kong and to identify factors associated with their screening behaviors. Method: 591 PSMI from community mental health services completed a cross-sectional survey. Results: The percentage of cancer screening behavior among those who met the criteria for particular screening recommendation was as follows: 20.8% for mammography; 36.5% for clinical breast examination (CBE); 40.5% for pap-smear test; 12.8% for prostate examination; and 21.6% for colorectal cancer screening. Results from logistic regression analyses showed that marital status was a significant factor for mammography, CBE, and pap-smear test; belief that cancer can be healed if found early was a significant factor for pap-smear test and colorectal screening; belief that one can have cancer without having symptoms was a significant factor for CBE and pap-smear test; belief that one will have a higher risk if a family member has had cancer was a significant factor for CBE; and self-efficacy was a significant factor for CBE and papsmear test behavior. Conclusions: Cancer screening utilization among PSMI in Hong Kong is low. Beliefs about cancer and self-efficacy are associated with cancer screening behavior. Health care professionals should improve the knowledge and remove the misconceptions about cancer among PSMI; self-efficacy should also be promoted

Web-Based Behavioral Intervention Utilizing Narrative Persuasion for HIV Prevention Among Chinese Men Who Have Sex With Men (HeHe Talks Project): Intervention Development

Background: In the era of potent antiretroviral therapy, a high level of condomless anal intercourse continues to drive increases in HIV incidence in recent years among men who have sex with men. Effective behavior change strategies for promoting HIV-preventive behaviors are warranted. Narrative persuasion is a novel health communication approach that has demonstrated its persuasive advantages in overcoming resistance to counterattitudinal messages. The efficacy of narrative persuasion in promoting health behavior changes has been well documented, but critical research gaps exist for its application to HIV prevention. Objective: In this study, we aimed to (1) capitalize on narrative persuasion to design a web-based multisession intervention for reducing condomless anal intercourse among men who have sex with men in Hong Kong (the HeHe Talks Project) by following a systematic development process; and (2) describe the main components of the narrative intervention that potentially determine its persuasiveness. Methods: Persuasive themes and subtopics related to reducing condomless anal intercourse were initially proposed based on epidemiological evidence. The biographic narrative interview method was used to elicit firsthand experiential stories from a maximum variation sample of local men who have sex with men with diverse backgrounds and experiences related to HIV prevention; different types of role models were established accordingly. Framework analysis was used to aggregate the original quotations from narrators into collective narratives under 6 intervention themes. A dedicated website was finally developed for intervention delivery. Results: A series of video-based intervention messages in biographic narrative format (firsthand experiential stories shared by men who have sex with men) combined with topic-equivalent argumentative messages were produced and programmed into 6 intervention sessions. The 6-week intervention program can be automatically delivered and monitored online. Conclusions: We systematically created a web-based HIV prevention intervention derived from peer-generated stories. Strategies used to enhance the efficacy of the narrative intervention have been discussed within basic communication components. This paper describes the methods and experiences of the rigorous development of a narrative communication intervention for HIV prevention, which enables replication of the intervention in the future

Problematic Internet Use and Smoking among Chinese Junior Secondary Students: The Mediating Role of Depressive Symptomatology and Family Support

Background: Internet use is significant public health issue and can be a risk factor for other addictive behaviors, such as smoking. The present study examined the association between problematic Internet use (PIU) (i.e., Internet addiction (IA) and social networking addiction (SNA)) and smoking, and the mediating role of depressive symptomatology and family support played in such associations. Methods: A cross-sectional study was conducted among 5182 junior secondary students (grade 7 and 8) recruited from nine schools using stratified sampling. Results: A total of 3.6% of students had smoked in the past month, and 6.4% of students were identified as IA cases. Adjusted for significant background variables, PIU (ORa = 2.07, 95% CI = 1.48, 2.90 for IA, ORa = 1.26, 95% CI = 1.09, 1.47 for SNA), and probable depression (ORa = 1.33, 95% CI = 1.05, 1.69) were significant risk factors, while family support (ORa = 0.85, 95% CI = 0.77, 0.94) was a significant protective factor of smoking. The mediation effects of lower family support and probable depression on the association between score on IA scale and smoking, and the mediation effect of lower family support on the association between score on SNA scale and smoking were significant, while the mediation effect of probable depression on the association between score on SNA scale and smoking was marginally significant. Conclusions: PIU contributed to an increased risk of smoking through depressive symptomatology and decreasing family support among junior school students. Interventions to reduce smoking are warranted; they should seek to reduce problematic Internet use and depressive symptomatology, and promote family support

Exercise interventions in the treatment of depression

Depression is a common psychiatric problem affecting millions of people worldwide. Whilst conventional treatments for depression have involved the use of antidepressant medications or ‘talking’ therapies, in recent years the concept of exercise therapy has received increasing attention as a potential alternative or supplementary treatment for depression. Research suggests that exercise interventions can be beneficial for alleviating depressive symptoms in individuals with a diagnosis of depression. Furthermore, it appears that exercise may be equally as effective as the use of antidepressant medications or psychotherapy. However, there are methodological shortcomings in much of the published literature, which may limit the generalisability of findings. There is a need for further well-designed research to clarify the role of exercise in the treatment of depression. Recommendations for future research and practice are outlined in this chapter