A longitudinal study on determinants of the intention to start smoking among Non-smoking boys and girls of high and low socioeconomic status

BACKGROUND: This study identifies differences in socio-cognitive factors as they relate to the intention to smoke among boys and girls living in high socioeconomic status (HSES) and low socioeconomic status (LSES) neighborhoods. METHODS: A total of 1,643 children (aged 10–12 years) completed a web-based questionnaire assessing their intention, attitude, social influences, and self-efficacy toward smoking at baseline and at one year follow-up. Logistic regression analyses were conducted to examine the relations between intention and predictor variables (i.e. attitude, social influence, and self-efficacy). Three-way interaction terms were added to the first analysis to examine potential interactions of gender, socioeconomic status and predictor variables. A 3-way interaction effect was present, and therefore subgroup analyses for HSES and LSES boys and girls were warranted. RESULTS: The results indicated that positive attitudes toward smoking were related to the intention to smoke among HSES boys, whereas HSES girls had higher intentions to smoke if they perceived fewer disadvantages of smoking (OR: 0.42; 95 % CI: 0.22–0.82). The intention to smoke among LSES boys was predicted by perceived social norms (OR: 0.49; 95 % CI: 0.25–0.93); in LSES girls, the smoking behavior of people in their environment was most strongly related to their smoking intention (OR: 5.55; 95 % CI: 2.81–10.93). CONCLUSIONS: To prevent youth smoking, HSES boys and girls may benefit from interventions that address attitudes. Boys from an LSES neighborhood may profit from smoking prevention interventions that target social norms, while LSES girls may benefit from strategies aimed at resisting the influence of smokers in their environment. TRIAL REGISTRATION: The ‘Fun without Smokes’ study is approved by the Medical Ethics Committee of the Atrium-Orbis-Zuyd Hospital (NL32093.096.11/MEC 11-T-25) and registered in the Dutch Trial Register (NTR3116)

A self-regulation eHealth intervention to increase healthy Behavior through general practice : protocol and systematic development

Background: Chronic diseases are the principal cause of morbidity and mortality worldwide. An increased consumption of vegetables and fruit reduces the risk of hypertension, coronary heart disease, stroke, and cancer. An increased fruit and vegetable (FV) intake may also prevent body weight gain, and therefore indirectly affect type 2 diabetes mellitus. Insufficient physical activity (PA) has been identified as the fourth leading risk factor for global mortality. Consequently, effective interventions that promote PA and FV intake in a large number of people are required. Objective: To describe the systematic development of an eHealth intervention, MyPlan 1.0, for increasing FV intake and PA. Methods: The intervention was developed following the six steps of the intervention mapping (IM) protocol. Decisions during steps were based upon available literature, focus group interviews, and pilot studies. Results: Based on needs assessment (Step 1), it was decided to focus on fruit and vegetable intake and physical activity levels of adults. Based on self-regulation and the health action process approach model, motivational (eg, risk awareness) and volitional (eg, action planning) determinants were selected and crossed with performance objectives into a matrix with change objectives (Step 2). Behavioral change strategies (eg, goal setting, problem solving, and implementation intentions) were selected (Step 3). Tablet computers were chosen for delivery of the eHealth program in general practice (Step 4). To facilitate implementation of the intervention in general practice, GPs were involved in focus group interviews (Step 5). Finally, the planning of the evaluation of the intervention (Step 6) is briefly described. Conclusions: Using the IM protocol ensures that a theory-and evidence-based intervention protocol is developed. If the intervention is found to be effective, a dynamic eHealth program for the promotion of healthy lifestyles could be available for use in general practice

Objective and perceived availability of physical activity opportunities: differences in associations with physical activity behavior among urban adolescents

ABSTRACT: BACKGROUND: This study examined the associations of the perceived and objective environment with adolescent engagement in sports activities and walking and cycling in leisure time. It also explored the degree of agreement between objective and perceived availability of physical activity (PA) facilities in neighborhoods. METHODS: Cross-sectional data on physical activity, the perceived availability of physical activity opportunities (perceived physical environment) was assessed through a questionnaire and the objective availability of PA opportunities (objective physical environment) was obtained through GIS data. The final sample included 654 adolescents with a mean age of 14.1 (SD = 1.2) years. RESULTS: Perceived availability of sports facilities and parks was significantly associated with engaging in sports (OR: 1.73; 95% CI: 1.16-2.56) and with walking and cycling in leisure time (OR: 1.66; 95% CI: 1.07-2.57) respectively. Agreement between objective and perceived environment was low to moderate with Kappa values ranging from -0.005 to 0.053. CONCLUSION: The perceived environment was the stronger correlate of PA behavior among adolescents. There were substantial differences between assessments of objective and perceived physical environmen

Ethical Aspects of the Scandals at Enron and WorldCom : From the Epilogue in Gibson (2007) Ethics and Business

textabstractObjectives: To examine psychosocial factors, BMI, perceived weight, and demographics as correlates of adolescents' intentions to prevent excessive weight gain. Methods: Students (12-13 years) completed questionnaires at baseline and 4-month follow-up. Regression analyses were performed (n=345). Results: Sixty percent showed a positive intention towards the prevention of excessive weight gain. A positive change in attitude and perceived internal control and higher perceived weight were related to a positive change in intention. Conclusion: A small majority of adolescents had a positive intention to prevent gaining excessive weight. A positive attitude and higher perceived internal control were related to a positive intention. Copyright (c) PNG Publications. All rights reserved

Do individual cognitions mediate the association of socio-cultural and physical environmental factors with adolescent sports participation?

Abstract Objective To examine the associations of perceived physical environmental factors (availability of physical activity (PA) attributes at home, PA facilities in the neighbourhood, neighbourhood pleasantness and safety) and social environmental factors (parental sports behaviour and parental rule regarding sports participation) with adolescent leisure-time sports participation, and to explore whether the associations found were mediated by individual cognitions as derived from the theory of planned behaviour (TPB). Design Cross-sectional study. Setting In schoolyear 2005/2006 adolescents from seventeen schools in Rotterdam, the Netherlands, completed a questionnaire during school hours that included self-reported measures of leisure-time sports participation, perceived physical environmental factors and TPB variables. Information about parental sports behaviour and parental rule was obtained from a questionnaire that was completed by one parent of the adolescents. Subjects Data were collected from 584 adolescent-parent combinations. Results Data were analysed with multi-level logistic regression analyses. Availability of PA attributes at home (OR = 1·26), parents' sports behaviour (OR = 2·03) and parental rule (OR = 1·64) were associated with a higher likelihood of adolescents' leisure-time sports participation. These associations were partly mediated by attitude and intention. Conclusions Adolescents were more likely to engage in leisure-time sports when PA attributes were available at home, when parents participated in sports activities and had a rule about their offspring participation in sports activities. These associations were partly mediated by attitude and intention. These results suggest that parents can importantly promote sports participation among their offspring by making sports activities accessible and a family routin

A Mobile Phone App Intervention Targeting Fruit and Vegetable Consumption:The Efficacy of Textual and Auditory Tailored Health Information Tested in a Randomized Controlled Trial

Background: Mobile phone apps are increasingly used to deliver health interventions, which provide the opportunity to present health information via different communication modes. However, scientific evidence regarding the effects of such health apps is scarce. Objective: In a randomized controlled trial, we tested the efficacy of a 6-month intervention delivered via a mobile phone app that communicated either textual or auditory tailored health information aimed at stimulating fruit and vegetable intake. A control condition in which no health information was given was added. Perceived own health and health literacy were included as moderators to assess for which groups the interventions could possibly lead to health behavior change. Methods: After downloading the mobile phone app, respondents were exposed monthly to either text-based or audio-based tailored health information and feedback over a period of 6 months via the mobile phone app. In addition, respondents in the control condition only completed the baseline and posttest measures. Within a community sample (online recruitment), self-reported fruit and vegetable intake at 6-month follow-up was our primary outcome measure. Results: In total, 146 respondents (ranging from 40 to 58 per condition) completed the study (attrition rate 55%). A significant main effect of condition was found on fruit intake (P=.049, partial eta(2)=0.04). A higher fruit intake was found after exposure to the auditory information, especially in recipients with a poor perceived own health (P=.003, partial eta(2)=0.08). In addition, health literacy moderated the effect of condition on vegetable intake 6 months later (P Conclusions: This study provides evidence-based insight into the effects of a mobile health app. The app seems to have the potential to change fruit and vegetable intake up to 6 months later, at least for specific groups. We found different effects for fruit and vegetable intake, respectively, suggesting that different underlying psychological mechanisms are associated with these specific behaviors. Based on our results, it seems worthwhile to investigate additional ways to increase fruit and vegetable intake in recipients with low health literacy

The ENDORSE study: Research into environmental determinants of obesity related behaviors in Rotterdam schoolchildren

Background: Children and adolescents are important target groups for prevention of overweight and obesity as overweight is often developed early in life and tracks into adulthood. Research into behaviors related to overweight (energy balance-related behaviors) and the personal and environmental determinants of these behaviors is fundamental to inform prevention interventions. In the Netherlands and in other countries systematic research into environmental determinants of energy balance related behaviors in younger adolescents is largely lacking. This protocol paper describes the design, the components and the methods of the ENDORSE study (Environmental Determinants of Obesity in Rotterdam SchoolchildrEn), that aims to identify important individual and environmental determinants of behaviors related to overweight and obesity and the interactions between these determinants among adolescents. Methods: The ENDORSE study is a longitudinal study with a two-year follow-up of a cohort of adolescents aged 12–15 years. Data will be collected at baseline (2005/2006) and at two years follow-up (2007/2008). Outcome measures are body mass index (BMI), waist circumference, time spent in physical activity and sedentary behaviors, and soft drink, snack and breakfast consumption. The ENDORSE study consists of two phases, first employing qualitative research methods to inform the development of a theoretical framework to examine important energy balance related behaviors and their determinants, and to inform questionnaire development. Subsequently, the hypothetical relationships between behavioral determinants, energy balance related behaviors and BMI will be tested in a quantitative study combining school-based surveys and measurements of anthropometrical characteristics at baseline and two-year follow-up. Discussion: The ENDORSE project is a comprehensive longitudinal study that enables investigation of specific environmental and individual determinants of overweight and obesity among younger adolescents. The project will result in specific recommendations for obesity prevention interventions among younger adolescents

Parental and child fruit consumption in the context of general parenting, parental education and ethnic background

This study examines the association between parental and child fruit consumption in the context of general parenting, parental education and ethnic background. A cross-sectional study was performed among 1762 parent-child dyads. Mean age of the children was 8. years. One parent completed a questionnaire to measure their own and their child's fruit consumption, parenting style, education level and ethnicity. In mediation and moderation analyses, child fruit consumption was regressed on parental fruit consumption, parenting style, parental education and ethnicity. Participating children consumed on average 7.5 pieces of fruit per week. Fourteen percent met the recommended Dutch norm of two pieces of fruit per day. Parental and child fruit consumption were positively associated. The association was more pronounced under higher levels of psychological control and behavioural control, and among ethnic groups. Additionally, parental education and child fruit consumption were positively associated. Parental fruit consumption partially mediated this association. Interventions are needed to increase child fruit consumption. Interventions should focus on increasing parental fruit consumption and positive parental modelling, with particular focus on low-SES families. Additionally, interventions that combine positive modelling with positive general parenting skills (e.g. increasing behavioural control) may be more effective than interventions that focus on parental modelling alone