Service providers' perspectives on barriers of healthy eating to prevent obesity among low-income children attending community childcare centers in South Korea:A qualitative study

This study aimed to identify individual and socio-ecological barriers in managing healthy eating among low-income children from the perspective of community childcare (CCC) center workers (n = 18) through focus group interviews. They perceived the increase in obesity among low-income children. The interviews revealed that the child's eating habits are affected by not only individual determinants including self-regulation and risk awareness but also environmental factors such as family, CCC centers, policy and social structure. To enhance children's health and behavior, it is necessary to consider the interactions among systems at a variety of levels, for example, local community and health care policies

Social cognitive determinants of fire safe behaviour in older adults

Background. Older adults are a high-risk group when it comes to fire in their homes. In this study we aimed to identify the most important predictors of fire safe behaviours among older adults. Methods. A questionnaire, consisting of 42 questions, was used to measure social cognitive determinants of fire safe behaviours. Findings. The findings showed that most respondents reported performing fire safe behaviours in their homes, in particular not connecting powerstrips to each other and cleaning the dryer lint filter. However, older adults do not feel very susceptible to the risk of residential fires as indicated by low scores on risk perception and susceptibility. Perceived behavioural control, attitude and response efficacy were found to be determinants that have unique contributions to the explanation of fire safe behaviours. In addition, this research showed that older adults perceive the emergency services, people who have experienced a house fire themselves, the municipality, and housing companies as reliable sources of communications about home fire prevention. Conclusion. The findings suggest that perceived behavioural control, attitude and response efficacy are important target variables for future interventions promoting fire safe behaviour among older adults. background

Non-participation in chlamydia screening in the Netherlands:determinants associated with young people’s intention to participate in chlamydia screening

Background: In the Netherlands, a national chlamydia screening program started in 2008, but the participation was low and the screening was not cost-effective. This study aimed to explore unconscious and conscious associations with chlamydia screening (16-29 year-olds). In addition, we examined whether information presented in chlamydia screening invitation letters had an effect on the evaluation of these determinants compared to a no-letter group. Methods: An Internet survey was conducted that included self-report measures of attitude, susceptibility, severity, unrealistic optimism, subjective, moral, and descriptive norm, perceived behavioral control, outcome expectations, barriers, intention, and a response time measure to assess unconscious associations of chlamydia screening with annoyance, threat and reassurance. Results: On the unconscious level, participants (N = 713) who received no information letter associated testing for chlamydia with annoyance and threat, but also with reassurance (all p's <.001). On the self-report measures, participants showed a low intention towards chlamydia screening (M = 1.42, range 1-5). Subjective norm, moral norm, perceived susceptibility and attitude were the most important predictors of the intention to screen (R-2 = .56). Participants who rated their susceptibility as high also reported more risky behaviors (p <.001). In the groups that received a letter (N = 735), a weaker unconscious association of chlamydia screening with annoyance was found compared with the no-letter group (p <.001), but no differences were found in reassurance or threat. Furthermore, the letters caused a higher intention (p <.001), but intention remained low (M = 1.74). On a conscious level, giving information caused a more positive attitude, higher susceptibility, a higher subjective and moral norm, and more positive outcome expectations (all p's <.001). Conclusion: Subjective norm, moral norm, susceptibility, and attitude towards chlamydia might be crucial targets to increase chlamydia screening behavior among sexually active young people. This study shows that informational invitation letters increase the intention and the intention-predicting variables. More evidence is needed on whether screening behavior can be increased by the use of an alternative information letter adapted to the specific unconscious and conscious determinants revealed in this study, or that we need other, more interactive behavior change methods

Strength exercises during physical education classes in secondary schools improve body composition: a cluster randomized controlled trial

Background: Metabolic health in people with obesity is determined by body composition. In this study, we examined the influence of a combined strength exercise and motivational programme –embedded in the school curriculum– on adolescents body composition and daily physical activity. Methods: A total of 695 adolescents (11-15y) from nine Dutch secondary schools participated in a one year cluster randomised controlled trial (RCT). In the intervention schools, physical education teachers were instructed to spend 15–30 min of all physical education lessons (2× per week) on strength exercises. Monthly motivational lessons were given to stimulate students to be more physically active. Control schools followed their usual curriculum. The primary outcome measure was body composition assessed by the deuterium dilution technique. Daily physical activity and sedentary behaviour measured by accelerometry served as a secondary outcome. Results: After 1 year, a 1.6% fat mass difference was found in favour of the intervention group (p = .007). This reflected a 0.9 kg difference in fat free mass (intervention>control; p = .041) and 0.7 kg difference in fat mass (intervention<control; p = .054). Daily physical activity decreased from baseline to posttest in both groups, but less so in the intervention group (p = .049). After 1 year, a difference of 0.4% was found for moderate to vigorous physical activities in favour of the intervention group (p = .046). No differences in sedentary behaviour, or light physical activity were found between groups. Conclusion: In 11–15 year olds, the combination of strength exercises plus motivational lessons contributed to an improvement in body composition and a smaller decrease in physical activity level

Reactions to threatening health messages

Background: Threatening health messages that focus on severity are popular, but frequently have no effect or even a counterproductive effect on behavior change. This paradox (i.e. wide application despite low effectiveness) may be partly explained by the intuitive appeal of threatening communication: it may be hard to predict the defensive reactions occurring in response to fear appeals. We examine this hypothesis by using two studies by Brown and colleagues, which provide evidence that threatening health messages in the form of distressing imagery in anti-smoking and anti-alcohol campaigns cause defensive reactions. Methods: We simulated both Brown et al. experiments, asking participants to estimate the reactions of the original study subjects to the threatening health information (n = 93). Afterwards, we presented the actual original study outcomes. One week later, we assessed whether this knowledge of the actual study outcomes helped participants to more successfully estimate the effectiveness of the threatening health information (n = 72). Results: Results showed that participants were initially convinced of the effectiveness of threatening health messages and were unable to anticipate the defensive reactions that in fact occurred. Furthermore, these estimates did not improve after participants had been explained the dynamics of threatening communication as well as what the effects of the threatening communication had been in reality. Conclusions: These findings are consistent with the hypothesis that the effectiveness of threatening health messages is intuitively appealing. What is more, providing empirical evidence against the use of threatening health messages has very little effect on this intuitive appeal