The Transtheoretical model for fruit, vegetable and fish consumption: associations between intakes, stages of change and stage transition determinants

BACKGROUND: Cardiovascular diseases are caused by multiple behavioral factors, including different dietary factors. We examined to what extent fruit, vegetable and fish consumption are related, and whether behavioral determinants vary across these dietary behaviors from a Transtheoretical model perspective. METHODS: Data were collected among 1142 participants (T0; response rate 46%) selected from an Internet panel, who were followed-up one-week later (T1; N = 1055, response rate 92%). Mean age was 35.4 (SD = 11.9) years, 35% was male, and most respondents were of Dutch origin (90%). Of the respondents, 13%, 44% and 43% had a low, medium or high level of education, respectively. Electronic questionnaires assessed fruit, vegetable and fish intake (food frequency questionnaires), stages of change, decisional balance and self-efficacy, for each of these three behaviors. RESULTS: Stages of change and (changes in) fruit, vegetable and fish intake were only weakly associated; decisional balance and self-efficacy were more strongly associated. Some presumed predictors of stage transitions were similar for fruit, vegetable, and fish intake, i.e., strong pros predicted progress out of precontemplators and low self-efficacy predicted relapse from action/maintenance for all behaviors. However, progress out of contemplation and out of preparation showed different patterns for fruit, vegetable and fish intake. CONCLUSION: The weak associations between intakes and potential determinants for fruit, vegetable, and fish consumption do not warrant an integrated dietary change approach targeting the same determinants for each behavior

Working at the nexus between public health policy, practice and research : dynamics of knowledge sharing in the Netherlands

BackgroundJoining the domains of practice, research and policy is an important aspect of boosting the quality performance required to tackle complex public health problems. “Joining domains” implies a departure from the linear and technocratic knowledge-translation approach. Integrating the practice, research and policy triangle means knowing its elements, appreciating the barriers, identifying possible cooperation strategies and studying strategy effectiveness under specified conditions.This article examines the dynamic process of developing an Academic Collaborative Centre for Public Health in the Netherlands, with the objective of achieving that the three domains of policy, practice and research become working partners on an equal footing.MethodAn interpretative hermeneutic approach was used to interpret the phenomenon of collaboration at the nexus between the three domains. The project was explicitly grounded in current organizational culture and routines, applied to nexus action. In the process of examination, we used both quantitative (e.g. records) and qualitative data (e.g., interviews and observations). The data were interpreted using the Actor-Network, Institutional Re-Design and Blurring the Boundaries theories.ResultsResults show commitment at strategic level. At the tactical level, however, managers were inclined to prioritize daily routine, while the policy domain remained absent. At the operational level, practitioners learned to do PhD research in real-life practice and researchers became acquainted with problems of practice and policy, resulting in new research initiatives.ConclusionWe conclude that working at the nexus is an ongoing process of formation and reformation. Strategies based on Institutional Re-Design theories in particular might help to more actively stimulate managers’ involvement to establish mutually supportive networks

Stigma of People with HIV/AIDS in Sub-Saharan Africa: A Literature Review

The aim of this literature review is to elucidate what is known about HIV/AIDS and stigma in Sub-Saharan Africa. Literature about HIV/AIDS and stigma in Sub-Saharan Africa was systematically searched in Pubmed, Medscape, and Psycinfo up to March 31, 2009. No starting date limit was specified. The material was analyzed using Gilmore and Somerville's (1994) four processes of stigmatizing responses: the definition of the problem HIV/AIDS, identification of people living with HIV/AIDS (PLWHA), linking HIV/AIDS to immorality and other negative characteristics, and finally behavioural consequences of stigma (distancing, isolation, discrimination in care). It was found that the cultural construction of HIV/AIDS, based on beliefs about contamination, sexuality, and religion, plays a crucial role and contributes to the strength of distancing reactions and discrimination in society. Stigma prevents the delivery of effective social and medical care (including taking antiretroviral therapy) and also enhances the number of HIV infections. More qualitative studies on HIV/AIDS stigma including stigma in health care institutions in Sub-Saharan Africa are recommended

Differential processing and attitude change following majority versus minority arguments

This experiment tested the general hypothesis that majority influence induces convergent processing, which stimulates attitude change on focal issues, whereas minority influence sometimes produces divergent processing, which might stimulate change on related attitudes. Results of a numerical support (majority vs. minority) by outcome involvement (high vs. low) experiment with attitude change and cognitive activity as dependent variables yielded partial support for these predictions. Majority arguments caused more attitude change on the focal issue than minority arguments, especially under high outcome involvement; no effects, however, were found for attitudes towards related issues. Consistent with expectations also was the result that, especially under high outcome involvement, cognitive activity predicted attitude change on the focal issue in the case of majority support, but generalization to related issues in the case of minority support for persuasive arguments. Results are interpreted as consistent with the general conclusion (a) that majority support is more effective than minority support in eliciting attitude change on local issues, (b) that both majority and minority support elicit cognitive activity, which predicts attitude change on focal issues in the case of majority support, but generalization in the case of minority support and (c) that these processes are especially strong when there is motivation to engage in systematic processing of persuasive arguments

Social Presence and Use of Internet-Delivered Interventions: A Multi-Method Approach

Objective Internet-delivered interventions can effectively change health risk behaviors and their determinants, but adherence to intervention websites once they are accessed is very low. This study tests whether and how social presence elements can increase website use. Methods A website about Hepatitis A, B, and C virus infections was used in a preparatory lab-based eye-tracking study assessing whether social presence elements attract participants\u27 attention, because this is a prerequisite for affecting website use. In the following field study, 482 participants representative of the Dutch population were randomized to either a website with or a website without social presence elements. Participants completed a questionnaire of validated measures regarding user perceptions immediately after exposure to the website. Server registrations were used to assess website use. Results Participants in the experimental condition focused on the social presence elements, both in terms of frequency (F(1, 98) = 40.34, p<.001) and duration (F(1, 88) = 39.99, p<.001), but did not differ in website use in comparison with the control condition; neither in terms of the number of pages visited (t(456) = 1.44, p = .15), nor in terms of time on the website (t(456) = 0.01, p = .99). Conclusions Adding social presence elements did not affect actual use of an intervention website within a public health context. Possible reasons are limited attention for these elements in comparison with the main text and the utilitarian value of intervention websites

FCMpy: A Python Module for Constructing and Analyzing Fuzzy Cognitive Maps

FCMpy is an open source package in Python for building and analyzing Fuzzy Cognitive Maps. More specifically, the package allows 1) deriving fuzzy causal weights from qualitative data, 2) simulating the system behavior, 3) applying machine learning algorithms (e.g., Nonlinear Hebbian Learning, Active Hebbian Learning, Genetic Algorithms and Deterministic Learning) to adjust the FCM causal weight matrix and to solve classification problems, and 4) implementing scenario analysis by simulating hypothetical interventions (i.e., analyzing what-if scenarios).Comment: 22 pages, 9 Figure

Blocked Goals, Persistent Action: Implementation Intentions Engender Tenacious Goal Striving

Research on goal attainment has demonstrated that people are more likely to reach their goals when they form implementation intentions. Three experiments tested whether implementation intentions lead to tenacious goal striving following blockage of an initial attempt to reach the goal. In all three experiments some participants were instructed to form an implementation intention and other participants were not. Subsequently, the initial goal-directed attempt of all participants was unexpectedly blocked. Experiment 1 found that implementation intentions resulted in more attempts to realize one’s goal. Experiment 2 showed that when participants formed an implementation intention their repeated attempt was acted out as intensely as their first, blocked attempt. Experiment 3 found that implementation intentions still allow people to seize an alternative, more onerous means to realize their intention. These results imply that implementation intention conserve self-regulatory strength. After goal blockage, the remaining strength can be used to continue goal-directed action