Electronic cigarettes: a survey of perceived patient use and attitudes among members of the British thoracic oncology group.

BACKGROUND: Smoking cessation following lung cancer diagnosis has been found to improve several patient outcomes. Electronic cigarette (e-cigarette) use is now prevalent within Great Britain, however, use and practice among patients with lung cancer has not as yet been explored. The current study aims to explore e-cigarette use among patients and examine current practice among clinicians. The results have important implications for future policy and practice. METHODS: Members of The British Thoracic Oncology Group (BTOG) were contacted via several e-circulations (N = 2,009), requesting them to complete an online survey. Of these, 7.7 % (N = 154) completed the survey, which explored participant demographics and smoking history, perceptions of patient e-cigarette use, practitioner knowledge regarding sources of guidance pertaining to e-cigarettes, and practitioner advice. RESULTS: Practitioners frequently observed e-cigarette use among patients with lung cancer. The majority of practitioners (81.4 %) reported responding to patient queries pertaining to e-cigarettes within the past year; however, far fewer (21.0 %) felt confident providing patients with e-cigarette advice. Practitioner confidence was found to differentiate by gender (p = 0.012) and employment speciality (p = 0.030), with nurses reporting particularly low levels of confidence in advising. The results also demonstrate extensive variability regarding the practitioner advice content. CONCLUSIONS: The results demonstrate that patients refer to practitioners as a source of e-cigarette guidance, yet few practitioners feel confident advising. The absence of evidence-based guidance may have contributed towards the exhibited inconsistencies in practitioner advice. The findings highlight that training should be delivered to equip practitioners with the knowledge and confidence to advise patients effectively; this could subsequently improve smoking cessation rates and patient outcomes

Exploring gender differences within forest schools as a physical activity intervention

This study investigated whether children engaged in more physical activity (PA) on school days that included Forest School (FS) sessions than a regular school day or a school day with a Physical Education (PE) lesson. How FS sessions influenced children’s general levels of PA and wellbeing was also explored across gender. A mixed-methods study followed a sample of 59 child participants aged 7 to 9 years old, from four primary schools, whilst taking part in twelve weekly FS sessions. Measures included the PA Questionnaire for Older Children and accelerometry data together with an individual Write and Draw task to inform focus groups. Children had significantly greater levels of light PA on a FS day and a PE school day compared to a regular school day and children reported feeling both happier and relaxed as a consequence of the intervention. From the qualitative data, boys and girls reported different likes of the FS interventions, whereas their dislikes of FS were comparable. Findings from this research provide evidence for such outdoor, nature-based learning within the school curriculum contributing to daily PA in children

Efficacy of the Best Possible Self protocol in diabetes self-management: A mixed-methods approach.

Recent research has demonstrated that positive affect may facilitate illness self-management. This study used a sequential exploratory mixed-methods typology to assess whether a brief writing task designed to boost positive affect (the Best Possible Self protocol) could improve aspects of diabetes self-management, specifically. A qualitative investigation explored people with diabetes' ( n = 20) views regarding Best Possible Self feasibility and acceptability, while a subsequent quantitative investigation assigned people with diabetes ( n = 50) to a Best Possible Self or non-Best Possible Self condition and assessed affect and self-management behaviours over a 4-week period. Findings indicated that individuals were receptive to the Best Possible Self and that it provided benefits for diabetes self-management

Positive Affect as a Buffer Against Psychopathology in Diabetes Patients: A Randomised Controlled Trial

The aim of this study was to assess a brief ‘positive’ psychological intervention’s effectiveness in facilitating positive affect amongst people with diabetes

Electronic cigarette use and risk perception in a Stop Smoking Service in England

Introduction: Electronic cigarette (e-cigarette) use rose substantially within the UK in recent years but currently, Stop Smoking Services in England do not prescribe them due to a lack of regulation. Previous research has examined e-cigarette use and attitudes within English Stop Smoking Services using samples of practitioners and managers; the current study recruited a sample of service users. Methods: Participants (N¼319) aged 18–60 years old were recruited from Roy Castle FagEnds, Liverpool, England (Stop Smoking Service). A cross-sectional questionnaire was completed, which recorded demographic variables, e-cigarette use alongside risk perception, and lastly, smoking behaviour i.e. smoking duration, cigarettes per day, and nicotine dependence. Results: Most participants were female (57.1%), current smokers (53.0%), and current or former e-cigarette users (51.7%). Participants who perceived e-cigarettes as less harmful than smoked tobacco were more likely to have smoked fewer cigarettes per day (p¼0.008). Furthermore, those who felt uncertain whether e-cigarettes were safer than smoked tobacco, were less likely to have tried them (p50.001). Conclusion: This study suggests that e-cigarette use is becoming common among users of Stop Smoking Services (despite e-cigarettes being unavailable from such services) and that e-cigarette risk perception is related to e-cigarette status. The results highlight the importance of providing smokers intending to quit smoking with current and accurate e-cigarette information. Findings may inform future Stop Smoking Services provision and the results demonstrate that further research is warranted

The best possible self‐intervention as a viable public health tool for the prevention of type 2 diabetes: A reflexive thematic analysis of public experience and engagement

Background: Public health initiatives seek to modify lifestyle behaviours associated with risk (e.g., diet, exercise, and smoking), but underpinning psychological and affective processes must also be considered to maximize success. Objective: This study aimed to qualitatively assess how participants engaged with and utilized the best possible self (BPS)-intervention specifically as a type 2 diabetes (T2D) prevention tool. Design and Methods: Fourteen participants engaged with a tailored BPS intervention. Reflexive thematic analysis analysed accounts of participant's experiences and feasibility of use. Results: All participants submitted evidence of engagement with the intervention. The analysis considered two main themes: Holistic Health and Control. The analysis highlighted several nuanced ways in which individuals conceptualized their health, set goals, and received affective benefits, offering insights into how people personalized a simple intervention to meet their health needs. Conclusions: To our knowledge, this is the first study to tailor the BPS intervention as a public health application for the prevention of T2D. The intervention enabled users to identify their best possible selves in a way that encouraged T2D preventive behaviours. We propose that our tailored BPS intervention could be a flexible and brief tool to assist public health efforts in encouraging change to aid T2D prevention. Public Contribution: The format, language and application of the BPS intervention were adapted in response to a public consultation group that developed a version specifically for application in this study

A grounded theory of type 2 diabetes prevention and risk perception

Objective Type 2 diabetes (T2D) prevention programmes should target high‐risk groups. Previous research has highlighted minimal engagement in such services from South Asian (SA) people. Given SA's elevated risk of T2D, there is a need to understand their perceptions, risks, and beliefs about T2D. Design This study aimed to assess T2D risk perception within a community sample of SA people using Grounded Theory methodology. Specifically, health beliefs were assessed, and we explored how these beliefs affected their T2D risk perceptions. Method Twenty SA participants (mean age = 38 years) without a diagnosis of T2D were recruited from community and religious settings across the North West of England. In line with grounded theory (Strauss & Corbin, 1990, Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park: Sage Publications), data collection and analysis coincided. Results The superordinate category of Culturally Situated Risk Perception incorporated a complex psychological understanding of the formation of T2D risk perception, which takes into account the social, cultural, and community‐based environmental factors. This superordinate category was explained via two core categories (1) Diminished Responsibility, informed by sub‐categories of Destiny and Heredity, and (2) Influencing Healthy Lifestyle Behaviours, informed by sub‐categories of Socio‐cultural and Environmental. Conclusion This study investigated risk perception of T2D within the SA community. When considering health prevention in the context of an individual’s culture, we need to consider the social context in which they live. Failure to acknowledge the cultural‐situated T2D risk perception relevant to health promotion and illness messages may account for the issues identified with health care engagement in the SA population

Cultural Identity Conflict Informs Engagement with Self-Management Behaviours for South Asian Patients Living with Type-2 Diabetes: A Critical Interpretative Synthesis of Qualitative Research Studies

The prevalence of type-2 diabetes (T2D) is increasing, particularly among South Asian (SA) communities. Previous research has highlighted the heterogeneous nature of SA ethnicity and the need to consider culture in SA patients’ self-management of T2D. We conducted a critical interpretative synthesis (CIS) which aimed to a) develop a new and comprehensive insight into the psychology which underpins SA patients’ T2D self-management behaviours and b) present a conceptual model to inform future T2D interventions. A systematic search of the literature retrieved 19 articles, including 536 participants. These were reviewed using established CIS procedures. Analysis identified seven constructs, from which an overarching synthesizing argument ‘Cultural Conflict’ was derived. Our findings suggest that patients reconstruct knowledge to manage their psychological, behavioural, and cultural conflicts, impacting decisional conflicts associated with T2D self-management and health professional advice (un)consciously. Those unable to resolve this conflict were more likely to default towards cultural identity, continue to align with cultural preferences rather than health professional guidance, and reduce engagement with self-management. Our synthesis and supporting model promote novel ideas for self-management of T2D care for SA patients. Specifically, health professionals should be trained and supported to explore and mitigate negative health beliefs to enable patients to manage social-cultural influences that impact their self-management behaviours. Keywords: type 2 diabetes; South Asian; culture; conflict; healthcare; qualitative; evidence synthesi

Identifying the key components of social support for patients living with type 2 diabetes: A protocol for a systematic review and meta-analysis of type 2 diabetes social support interventions

Type 2 diabetes (T2D) is a disease that impacts a huge portion of the world's population. The number of T2D cases is expected to keep rising during the next decade. Committing to the treatment to manage this condition makes participants feel a burden of emotions making them require emotional support from caregivers or close ones. Support from family or caregivers can help improve glycaemia control, medication adherence, and T2D self-management. However, little is known about what aspects of social support effectively improve patients' T2D self-management outcomes. The aim of this systematic review and meta-analysis is to identify the effective components of social support that can help participants improve their T2D self-management. Methods: The protocol of this review was developed based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The PRISMA recommendations were applied to develop a search strategy in collaboration with a team of academics to identify relevant T2D social support interventions via healthcare and psychology databases, Medline, Web of Science, ProQuest, CINHAL. Discussion: This review will provide an overview of what intervention social support components have a significant impact on T2D glycaemia control. These findings will inform future T2D interventions on what social support components could be used to encourage better diabetes self-management and glycemic control

Health professionals interface with cultural conflict in the delivery of type 2 diabetes care.

OBJECTIVE: This study explored the knowledge and experiences of health professionals (HPs) caring for South Asian patients with type 2 diabetes (T2D). DESIGN: Fourteen HPs, who supported patients with T2D, were interviewed. The recruitment strategy employed purposeful and theoretical sampling methods to recruit HPs who worked across primary and secondary care settings. MAIN OUTCOME MEASURES: Grounded Theory (GT) methodology and analysis generated a theoretical framework that explored HP's perceptions and experiences of providing diabetes care for South Asian patients. RESULTS: A GT, presenting a core category of Cultural Conflict in T2D care, explores the influences of HP's interactions and delivery of care for South Asian patients. This analysis is informed by four categories: (1) Patient Comparisons: South Asian vs White; (2) Recognising the Heterogeneous Nature of South Asian Patients; (3) Language and Communication; (4) HPs' Training and Experience. CONCLUSIONS: The findings consider how the role of social comparison, social norms, and diminished responsibility in patient self-management behaviours influence HPs' perceptions, implicit and explicit bias towards the delivery of care for South Asian patients. There was a clear call for further support and training to help HPs recognise the cultural-ethnic needs of their patients