Adapting and Evaluating a Theory-Driven, Non-Pharmacological Intervention to Self-Manage Pain

BACKGROUND: The existing literature has limited detail on theory-driven interventions, particularly in pain studies. We adapted Bandura\u27s self-efficacy framework toward a theory-driven, non-pharmacological intervention using auricular point acupressure (APA) and evaluated participants\u27 perceptions of this intervention on their pain self-management. APA is a non-invasive modality based on auricular acupuncture principles. METHODS: We mapped our study intervention components according to Bandura\u27s key sources of self-efficacy (performance accomplishments, vicarious experience, verbal persuasion, and emotional arousal) to facilitate the self-management of pain. Through a qualitative study design, we conducted virtual interviews at one and three months after a 4-week APA intervention among 23 participants using purposive sampling to describe their experiences in managing their pain based on our theory-driven APA intervention. RESULTS: Using thematic analyses, we found four themes: the enhanced self-management of pain, improved pain outcomes, the feasibility of technology, and the sustainability of APA. CONCLUSIONS: Describing how interventions are mapped according to the elements of theoretical frameworks can help to guide intervention development, advance science and knowledge development, and promote the implementation of interventions. As such, using Bandura\u27s self-efficacy theory as a foundation for the APA intervention, APA was found to be feasible and sustainable, improving self-management, pain intensity, and pain-related outcomes. Participants provided recommendations for the further improvement of this theory-driven intervention

Interactions between drinking motives and friends in predicting young adults' alcohol use

While drinking motives are well-established proximal predictors of alcohol use, less is known about their role in event-level drinking behavior. The present study examines whether the interaction between individuals' drinking motives and the number of friends present at a given moment can predict alcohol consumption over the course of the evening. Using the Internet-based cell phone-optimized assessment technique (ICAT), 183 young adults (53.0 % female, mean age = 23.1) in French-speaking Switzerland completed cell phone questionnaires every Thursday, Friday, and Saturday evening over five weekends. A total of 7205 questionnaires completed on 1441 evenings were analyzed. Drinking motives and gender were assessed at baseline, while the hourly alcohol consumption rate and number of friends present were assessed at 8 p.m., 9 p.m., 10 p.m., 11 p.m., and midnight. Multilevel growth curve models with time-invariant and time-varying covariates were estimated for men and women separately. Among women, enhancement motives were associated with an increase in the hourly alcohol consumption rate over the course of the evening (b = .025; p < .05). The impact of the number of friends present on the hourly consumption rate was stronger among those women who scored high on coping motives at baseline (b = .028; p < .05). Among men, drinking motives were found to have no moderating effects. Results highlight the role of drinking motives and their interactions with situational characteristics in determining event-level drinking, especially among women. Strategies to prevent risky weekend drinking should focus on both the social environment in which drinking takes place (e.g., the drinking group) and individual drinking motives

The impact of friends on young adults' drinking over the course of the evening-an event-level analysis

Item does not contain fulltextAims To examine whether young adults' alcohol consumption during the course of an evening was affected by the number of friends present, and the interaction between participants' gender and number of friends present. Design Participants used the internet-based cellphone-optimized assessment technique (ICAT) to complete a series of cellphone questionnaires every Thursday, Friday and Saturday evening over five weekends. A multi-level growth curve model (hourly assessments, clustered within evenings, clustered within individuals) with time-invariant and time-varying covariates was estimated. Setting French-speaking Switzerland. Participants A total of 183 young adults (53.0% female, mean age= 23.1) who completed 7205 questionnaires on 1441 evenings. Measurements Alcohol consumption and number of friends present assessed at 8 p.m., 9 p.m., 10 p.m., 11 p.m. and midnight. Findings Drinking pace accelerated notably over the course of the evening on Saturdays (b= 0.047; P< 0.01). Men consumed more alcohol than women, particularly at the beginning of the evening (b= 0.152; P< 0.05). However, this effect was no longer significant when the impact of friends was accounted for (b= 0.096; P= 0.139). The higher the number of friends present, the higher the number of drinks consumed at a given time during the course of the evening (b= 0.070; P< 0.001). Cross-level interaction effects indicated that this relationship was stronger for men than women (b= 0.027; P< 0.05). Conclusions Among young adults in Switzerland, the number of friends present is associated positively with hourly drinking frequency during the course of weekend evenings. The impact of the drinking group size on alcohol use is stronger for men than women

The impact of school nonresponse on substance use prevalence estimates - Germany as a case study.

Background The European School Survey Project on Alcohol and Other Drugs (ESPAD) is a survey study that collects comparable data on substance use of students aged 15 to 16 years old in European countries. The present study aims at investigating the impact of school refusal to participate in ESPAD on substance use prevalence estimates. Methods Data came from the 2007 German ESPAD study; the sample consisted of 12,246 students in 552 schools within seven German federal states. A simulation approach was used in order to study the effects of systematic exclusion of participating schools on prevalence estimates of key ESPAD outcomes including the use of tobacco, alcohol, cannabis, and other illegal drugs. Results The systematic exclusion of schools based on city-, school-, and class size, school environment, and schools&rsquo; substance use policies resulted in significant changes in prevalence estimates in 23 of 25 examined combinations of selection criterion and outcome. Yet, these effects were small, with differences remaining below 3 percentage points around the original estimates. Conclusions This simulation approach suggests that nonparticipation of schools in surveys on students&rsquo; substance use in Germany do not largely affect the validity of resulting prevalence estimates. Even a reduced number of schools may be sufficient to gain valid prevalence figures

Binge drinking: Health impact, prevalence, correlates and interventions.

Binge drinking (also called heavy episodic drinking, risky single-occasion drinking etc.) is a major public health problem. This paper provides an overview of recently published evidence concerning the definition and measurement, prevalence rates, health impact, demographic and psychosocial correlates of, and interventions for, binge drinking. Narrative review. Mostly occurring among young people at weekends, binge drinking increases the risk of both acute (e.g. injuries) and long-term negative consequences (e.g. alcohol disorders). Binge drinkers tend to be extrovert, impulsive and sensation-seeking. Stress, anxiety, traumatic events and depression are also related to binge drinking. Both alcohol-related behaviour of parents and general parenting (e.g. parenting styles, monitoring) are also important. Other major risk factors for binge drinking are frequently spending time with friends who drink, and the drinking norms observed in the wider social environment (e.g. school, community, culture). Emergency departments, birthday parties, fraternities and the workplace serve as settings for interventions; these are increasingly delivered via digital and mobile technology. There is evidence of small-sized effects across approaches (brief interventions, personalised normative feedback, protective behavioural strategies etc.) and populations. A more consistent terminology, investigating multi-level influences and identifying the most effective intervention components are challenges for future research

Adolescents' protection motivation and smoking behaviour

Contains fulltext : 116629.pdf (publisher's version ) (Open Access)The protection motivation theory (PMT) is a well-known theory of behaviour change. This study tested the applicability of the sub-constructs of threat and coping appraisal in predicting adolescents' smoking-related behavioural intentions and smoking behaviour longitudinally. Adolescents (N = 494) aged 11-16 years and not currently smoking at baseline participated in the study. Predictive validity of PMT constructs was tested in a path analysis model. Self-efficacy significantly predicted behavioural intention at baseline, which significantly predicted behavioural intention at follow-up, which in turn predicted smoking behaviour at follow-up. The effect of self-efficacy on behavioural intention at follow-up was mediated by behavioural intention at baseline and the effect of self-efficacy on smoking behaviour was mediated by behavioural intention at baseline and follow-up. In conclusion, we found support for one part of the PMT, namely for the predictive validity of the coping appraisal construct self-efficacy in predicting adolescents' smoking-related behavioural intention and smoking behaviour. These results fail to support the appropriateness of the PMT's construct threat appraisal in longitudinally predicting adolescents' smoking as well as the applicability of communicating fear and negative information as preventive interventions for this target group

Peer mentoring and automated text messages for smoking cessation: a randomized pilot trial

Introduction Text-messaging programs for smoking cessation, while efficacious, have high dropout rates. To address this problem, we developed and tested the feasibility and early efficacy of a peer-mentoring intervention for smoking cessation provided by former smokers. Methods Adult US smokers were recruited nationally into a randomized pilot trial (N = 200), comparing 6–8 weeks of automated text-messaging support (SmokefreeTXT) and automated text support plus personalized texts from a peer mentor who formerly smoked. The primary outcome was biochemically verified 7-day point-prevalence abstinence at 3 months post-quit date, assessed on an intention-to-treat basis (missing = smoking). Self-reported abstinence, program acceptability, user engagement, and user perceptions were also assessed. Results Biochemically verified abstinence at 3 months was 7.9% (8/101) in the intervention group and 3.0% (3/99) in the control group (adjusted difference 6.5, 95% CI = 0.7% to 12.3%; p = .03). Self-reported abstinence at 3 months was 23.8% (24/101) in the intervention group versus 13.1% (13/99) in the control group (adjusted difference 12.7, 95% CI = 1.2% to 24.1%; p = .03). The intervention had a positive but insignificant effect on overall satisfaction (78.3% vs. 72.9% control group, p = .55). Having a mentor did not significantly alter duration of interaction with the program nor the proportion unsubscribing, although the intervention group reset their quit date with greater frequency (p Conclusions Peer mentoring combined with automated text messages was feasible and acceptable and increased smoking abstinence compared with automated messages alone. The results highlight the promise of this intervention approach and the need for a full-scale evaluation. Implications Providing quitting assistance by automated text messaging has been shown to increase smoking abstinence. Yet, dropout rates in text-messaging programs are high. No studies have tested the effectiveness of peer mentors who are former smokers as part of a text-messaging intervention, although they represent a promising way to retain, engage, and support smokers. This randomized pilot trial suggests that peer mentors can complement automated text-messaging programs to promote smoking abstinence.</p