Overestimation of Drinking Norms and its Association with Alcohol Consumption in Apprentices

Aims: To investigate associations of normative misperceptions and drinking behaviors in apprentices, complementing the previous literature on university students. Methods: A survey in a defined region of northern Germany was carried out among 1124 apprentices attending vocational schools. Using items from the short form of the Alcohol Use Disorders Identification Test (AUDIT-C), drinking behaviors and normative perceptions of drinking in the reference group of same-gender apprentices were assessed. Demographic, smoking- and drinking-related predictors for normative misperceptions were explored. Results: Personal drinking behavior was positively correlated with perceived norms, both for drinking frequency (males: Kendall's τ=0.33, P<0.01; females: τ=0.22, P<0.01) and drinking quantity (males: Kendall's τ=0.39, P<0.01; females: τ=0.25, P<0.01). Alcohol use disorders according to AUDIT-C cut-offs were more prevalent in subjects who overestimated drinking quantity in their reference group than in those who correctly estimated or underestimated drinking quantity (male: P<0.01; relative risk (RR) 1.78; female: P<0.01; RR 1.65). Concerning drinking frequency, this difference was only found in males (P<0.01; RR 1.49). Male gender and higher alcohol use were positively associated with normative misperceptions of both drinking quantity and frequency. Conclusion: Interventions correcting alcohol use misperceptions might be effective in reducing problem drinking in adolescents with heterogeneous educational level

Behavioral Health Risk Factors and Motivation to Change among Cardiovascular General Hospital Patients Aged 50 to 79 Years

Little is known about the (co-)occurrence of smoking, alcohol at-risk drinking, physical inactivity and overweight, and the motivation to change these behavioral health risk factors (HRFs) in older general hospital patients with cardiovascular disease. Between October and December 2016, all consecutively admitted patients aged 50 to 79 years were proactively recruited on 3 cardiology wards and asked to participate in a survey on HRFs and behavior change motivation. Of the eligible patients, 80.4% participated in the survey (n = 328). The mean age was 66.5 years (standard deviation 9.0), and 65.5% were male. At least 1 HRF was present in 91.8% (n = 280), at least 2 HRFs in 54.4% (n = 166), and 3 or 4 HRFs in 12.1% (n = 37) of participants. The proportion of older adults who contemplated or were changing or planning to change their behavior to meet health behavior recommendations ranged between 66.0% (smoking) and 93.2% (alcohol consumption). The results indicate a notable co-occurrence of behavioral HRFs in older patients with cardiovascular disease. The majority of older adults were at least considering changing the respective behavior. To prevent and treat diseases efficiently, hospitalization may be a suitable moment for systematic multiple HRF screening and intervention.Peer Reviewe

Reasons for not using smoking cessation aids

© 2008 Gross et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Die Förderung der Intention zur Tabakabstinenz in der Hausarztpraxis – Merkmale von Hausärzten

Hintergrund: Das Tabakrauchen ist in den Industrienationen der bedeutendste vermeidbare Faktor unter den Gesundheitsrisiken. Daher ist die Senkung der Prävalenz ein wichtiges Ziel der Präventivmedizin. Verschieden Studien haben gezeigt, dass kurze und proakive Interventionen, wie eine Beratung oder der Ratschlag eines Hausarztes, die Wahrscheinlichkeit eines Rauchstopps erhöhen. Hausärzte erreichen einen großen Anteil der Raucher in ihrer Praxis. Obwohl kosteneffektive Interventionen verfügbar sind und deren Anwendung in den Leitlinien empfohlen wird, erfolgen sowohl ein systematisches Screening bezüglich des Rauchstatus als auch ein Beratungsangebot zum Rauchen im Praxisalltag bislang unzureichend. Das Ziel dieser Studie war es zu untersuchen 1) in welchem Umfang Raucher mit einem systematischen Beratungsangebot erreicht werden können, (2) welches Beratungsverhalten bei Hausärzten nach einer Schulung erzielt werden kann, wenn organisatorische Unterstützung stattfindet, (3) ob zwischen dem Rauchstatus des Hausarztes und der Wirksamkeit einer Kurzberatung ein Zusammenhang besteht. Methode: Die Daten wurden im Rahmen der Studie Pro GP „Proactive interventions for smoking cessation in General medical Practices“ erhoben. In dieser Studie wurde mit einem quasi experimentellen Design die Wirksamkeit von Interventionen zur Tabakabstinenz untersucht. Dazu wurde eine Auswahl von 39 Hausarztpraxen zufällig gezogen, 34 Praxen nahmen teil. Die Hausärzte erhielten eine Schulung von bis zu zwei Stunden in ihrer Praxis. Alle Patienten, die die Praxis im Verlauf einer Woche aufsuchten, wurden nach ihrem Rauchstatus gefragt (N=3434). Die Einschlusskriterien der Studie, aktuell Raucher und zwischen 18 und 70 Jahre alt erfüllten n=551 Patienten, 81,8% nahmen an der Studie teil. Mit einem Dokumentationsbogen, ausgefüllt durch eine Studienassistentin, wurden tabakrauchbezogenen Angaben des Patienten an den Hausarzt weitergeleitet. Der Hausarzt wurde darauf hingewiesen, für jeden Patienten nach der Beratung eine Kurzdokumentation auszufüllen. Die Patienten wurden 6, 12, 18 und 24 Monate nach der Kurzberatung wiederbefragt. Die Daten im Querschnitt wurden deskriptiv analysiert und eine logistische Regression gerechnet. Im Längsschnitt fand aufgrund der hierarchischen Struktur der Daten eine Multilevel Analyse Anwendung. Ergebnisse: Die Prävalenz des Rauchens unter den Hausärzten lag bei 24,6%. Weiterhin zeigten die Daten, dass 45,9% (n=17) der Hausärzte regelmäßig den Rauchstatus der Patienten bei Erstvorstellung in der Praxis erheben. Häufige genannte Barriere gegen die Beratung von Rauchern war neben Zeitknappheit, das vermutetes mangelndes Interesse auf Seiten der Patienten. In 96% (n=433) der Fälle konnte der Hausarzt das Thema Rauchen ansprechen und in 87% (n=396) dokumentierten die Hausärzte, dass ein Beratungsgespräch zum Rauchen stattgefunden hat. Eine logistische Multilevel- Regression hat gezeigt, dass durch die Kurzberatung, durchgeführt von einem nichtrauchenden Hausarzt bei den Patienten eine erhöhte Wahrscheinlichkeit für eine 24 Stunden- Nikotin- Abstinenz besteht. Eine schwächere Assoziation wurde für das Maß der 4- Wochen- prolongierten Tabakabstinenz gefunden. Diskussion: Trotz der berichteten und wahrgenommenen Barrieren wurde die Beratung von Rauchern durch die Hausärzte umgesetzt. Mit maßgeschneiderten Interventionskonzepten können nahezu alle rauchenden Patienten erreicht werden. Dass Hausärzte selbst mit dem Rauchen aufhören ist eine wichtige Voraussetzung, um ein persönliches und für die Patienten effektives Kurzberatungsangebot zu implementieren. Es sind spezielle Angebote, z. B. von Berufsverbänden erforderlich, damit sich die Motivation unter Ärzten, mit dem Rauchen aufzuhören, erhöht.Summary Background: Tobacco smoking is the single most preventable health risk factor in industrialized countries. Therefore reducing the smoking prevalence is an important aim in the area of preventive medicine. Several studies established that brief and proactive interventions such as counselling or advice delivered by the general practitioner (GP) increase the odds of quitting in patients. General practitioners can reach a large number of smokers. Despite the availability of cost-effective interventions and the recommendation of these interventions by major practice guidelines, the transfer of systematic screening and counselling concerning smoking in the practice routine has been insufficient. The goal of the study was to examine: (1) to what extent smokers can be reached, when a counselling intervention is offered systematically, (2) which counselling behaviour among GPs can be achieved after training when organizational support is provided, (3) whether the smoking status of the GP and the efficacy of the intervention were associated. Methods: Data were collected during the study Pro GP “Proactive interventions for smoking cessation in General medical Practices”. The study comprised a quasi experimental smoking cessation intervention study. A random sample of 39 general practices was drawn, 34 took part. GPs received a training session of up to two hours in their practices. All patients showing up during the period of one week were asked about their smoking status (N=3434). Current smokers aged 18-70 years were eligible (N=551), 81,8% participated. A documentation sheet, filled in by the study nurse, transferred smoking related information about the patient to the GP. GPs were advised to fill in a post counselling assessment for every patient. Follow up assessments among patients were conducted 6, 12, 18, and 24 months after baseline. Data analysis for cross sectional data included descriptive statistics and logistic regression analysis. Because of the hierarchical structure of the data, multilevel analysis for longitudinal data was carried out. Results: The prevalence of smoking among GPs was 24,6%. Furthermore data revealed that 45,9% (N=17) of the GPs regularly assessed the smoking status at initial visits of new patients. Frequent barriers for smoking counselling were lack of time and the assumption that patients were not motivated to quit. In 96% (N=433) of the counselling sessions, the GPs addressed smoking, and in 87% (N=396), the GPs documented counselling. Multi level regression revealed that a single smoking counselling session by non-smoking GP produced a higher 24- hour prevalence abstinence among patients. A weaker association was found for the 4-week prolonged abstinence. Discussion: Despite reporting and perceiving barriers, GPs indicated provision of smoking counselling activity. Tailored intervention concepts can reach almost all smoking patients. Smoking cessation of the GPs is a prerequisite to implement personal counselling which is effective on the patient level. Therefore special offers e.g. from practitioner professional organization fostering their motivation to quit smoking are important measures

Die Adhärenz Erwachsener an der Bewegungsaufzeichnung über 7 Tage mittels Akzelerometer

Hintergrund: Über den Einsatz direkter Messmethoden zur Erfassung körperlicher Aktivität bei Erwachsenen in Deutschland ist bislang wenig bekannt. Ziel der Studie ist die Beschreibung der Adhärenz und die Analyse individueller Determinanten, ein Akzelerometer über 7 Tage zu tragen. Material und Methoden: In einem Einkaufszentrum wurden 365 Personen (40 bis 75 Jahre) für eine 7-tägige Aufzeichnung ihrer körperlichen Aktivität gewonnen. Von diesen hatten 231 (63,3 %) das Gerät täglich mindestens 10 h getragen. Ergebnisse: Teilnehmende in Partnerschaft trugen das Akzelerometer mit höherer Wahrscheinlichkeit entsprechend der Anweisung verglichen mit jenen ohne Partnerschaft. Schlechtere subjektive Gesundheit war mit einer geringeren Einhaltung der Anweisungen, das Akzelerometer zu tragen, assoziiert. Diskussion: Um möglichst valide Daten über Umfang und Intensität körperlicher Aktivität zu erhalten, sollten Menschen ohne Partner und solche mit schlechterer subjektiver Gesundheit über den Tragezeitraum des Gerätes hinweg motiviert werden, es regelmäßig zu tragen

Predictors of indoor smoking at young children’s homes—a cross-sectional study

The aim of the study was to determine factors associated with indoor smoking in homes (ISIH) using a sample of households with at least one child aged 3 or younger and at least one smoking adult. In a defined German region, all households (n = 3,570) with a child aged 3 or younger were invited to participate in a study that tested the efficacy of an intervention for reducing exposure to environmental tobacco smoke. In 1,282 households, at least one parent reported daily smoking. Among these, 917 (71.5 %) participated in the study. ISIH was defined as smoking ‘in specific rooms only’ or ‘everywhere’. Cross-sectional data were analysed using regression analysis. Among the households, 37.5 % reported ISIH. ISIH was more likely if the youngest child had not visited a nursery (OR, 1.81; CI, 1.21–2.70) and if no private outdoor area was present (OR = 4.38, CI, 2.64–7.25). Lower household education level and partly unemployment in dual-parent households were associated with ISIH. Conclusion: Fostering nursery attendance and availability of a private outdoor area may protect young children living in household with smoking parents from environmental tobacco smoke

The effect of mere measurement from a cardiovascular examination program on physical activity and sedentary time in an adult population

Abstract Background Measuring physical activity (PA) and sedentary time (ST) by self-report or device as well as assessing related health factors may alter those behaviors. Thus, in intervention trials assessments may bias intervention effects. The aim of our study was to examine whether leisure-time PA, transport-related PA, and overall ST measured via self-report vary after assessments and whether a brief tailored letter intervention has an additional effect. Methods Among a sample of subjects with no history of myocardial infarction, stroke, or vascular intervention, a number of 175 individuals participated in a study comprising multiple repeated assessments. Of those, 153 were analyzed (mean age 54.5 years, standard deviation = 6.2; 64% women). At baseline, participants attended a cardiovascular examination (standardized measurement of blood pressure and waist circumference, blood sample taking) and wore an accelerometer for seven days. At baseline and after 1, 6, and 12 months, participants completed the International Physical Activity Questionnaire. A random subsample received a tailored counseling letter intervention at month 1, 3, and 4. Changes in PA and ST from baseline to 12-month follow-up were analyzed using random-effects modelling. Results From baseline to 1-month assessment, leisure-time PA did not change (Incidence rate ratio = 1.13, p = .432), transport-related PA increased (Incidence rate ratio = 1.45, p = .023), and overall ST tended to decrease (b = − 1.96, p = .060). Further, overall ST decreased from month 6 to month 12 (b = − 0.52, p = .037). Time trends of the intervention group did not differ significantly from those of the assessment-only group. Conclusions Results suggest an effect of measurements on PA and ST. Data of random-effects modelling results revealed an increase of transport-related PA after baseline to 1-month assessment. Decreases in overall ST may result from repeated assessments. A brief tailored letter intervention seemed to have no additional effect. Thus, measurement effects should be considered when planning intervention studies and interpreting intervention effects. Trial registration ClinicalTrials.gov NCT02990039 . Registered 7 December 2016. Retrospectively registered