Psychosocial determinants of intention to abstain from drinking alcohol while pregnant among a sample of women of childbearing age

In many countries, not drinking alcohol during pregnancy is strongly recommended, since consuming alcohol can be hazardous for the unborn child. Despite this, a number of women drink alcohol while pregnant. The two objectives of the study were to identify (1) the determinants of intention to abstain from drinking alcohol while pregnant among 167 women of childbearing age between the ages of 18 and 44, and (2) the factors that programs promoting alcohol abstinence during pregnancy should consider. Data was collected using a questionnaire based on an extended version of the theory of planned behaviour. A large majority of the participants reported consuming alcohol on a regular basis. Although most of them expressed a strong intention to abstain from alcohol during pregnancy, about one woman in four did not have a firm intention. A logistic regression analysis revealed that the four determinants of intention were moral norm (odds ratio [OR] = 12.97; 95% confidence interval [CI95%]: 3.83-43.91), anticipated regret (OR = 11.43; CI95%: 3.46-37.75), attitude (OR = 7.49; CI95%: 2.37-23.64) and perceived behavioural control (OR = 3.60; CI95% 1.11-11.65). Moreover, a discriminant analysis identified specific beliefs significantly related to intention not to consume alcohol while pregnant. These results can prove useful in guiding the development of a program promoting alcohol abstinence among women of childbearing age in order to reduce the number of unborn children exposed to alcohol during pregnancy

Les déterminants de l'intention des femmes en âge de procréer de s'abstenir de l'alcool lors d'une future grossesse

Santé Canada recommande l'abstinence de l'alcool durant la grossesse puisque la consommation d'alcool peut être dangereuse pour le développement du foetus et causer un ensemble de troubles causés par l'alcoolisation foetale (ETCAF). L'objectif de la présente étude était d'identifier les déterminants de l'intention de s'abstenir de l'alcool lors d'une future grossesse chez des femmes en âge de procréer à l'aide d'un modèle intégrateur incluant la théorie du comportement planifié. L'intention de s'abstenir de l'alcool était très élevée avec un score moyen de 6,75 sur 7. La régression logistique a révélé que les quatre déterminants de l'intention étaient la norme morale (RC=12,97; IC95%: 3,83-43,91), le regret anticipé (RC=11,43; 1C95%: 3,46-37,75), l'attitude (RC=7,49; 1C95%: 2,37-23,64) et la perception du contrôle comportemental (RC=3,60; IC95%: l, Il-Il , 65). Ces résultats peuvent guider l'élaboration d'un programme de promotion de l'abstinence de l'alcool afin de diminuer le nombre d'enfants exposés durant la grossesse

Determinants and interventions to promote water consumption among adolescents : a review of the recent literature

Purpose of review. This review summarizes the latest scientific evidence on determinants and interventions to promote water consumption among adolescents. Recent findings. We identified 15 studies on determinants of water consumption and 11 interventions to promote water consumption among adolescents. Determinants of adolescent’s water consumption included individual (e.g., physiological, demographic, psychological and behavioral variables), social (e.g., peer influence) and environmental (e.g., availability of water at school and at home) ones and school policies. Interventions with both educational/behavioral and legislative/environmental components seem the most promising to promote water consumption among adolescents. Summary. To our knowledge, this is the first review integrating the results on both determinants of, and interventions to promote, water consumption among adolescents. Gaps in the scientific literature were identified and recommendations to improve future studies were given. Promoting water consumption among adolescents could be a promising avenue to lower obesity and promote early acquisition of healthy dietary habits

La promotion de la saine alimentation chez des femmes à risque de développer du diabète gestationnel

Tableau d'honneur de la Faculté des études supérieures et postdoctorales, 2016-2017L’objectif général de la thèse est d’identifier des moyens novateurs afin de promouvoir la saine alimentation, soit la consommation de fruits et légumes, chez des femmes à risque de développer du diabète gestationnel. L’Intervention Mapping a servi de cadre pour planifier les étapes nécessaires au développement de l’intervention. Pour atteindre l’objectif de la thèse, quatre projets de recherche distincts, mais complémentaires ont été réalisés. Le premier projet de recherche impliquait d’effectuer une revue systématique sur la validation des mesures auto-déclarées de l’alimentation durant la grossesse. L’objectif était de recenser les méthodes utilisées pour mesurer l’alimentation durant la grossesse et de vérifier leurs qualités psychométriques pour identifier les outils à privilégier pour évaluer l’alimentation des femmes enceintes. L’objectif du deuxième projet de recherche était de valider un court questionnaire sur la consommation de fruits et légumes chez des femmes enceintes. Le troisième projet était une recherche formative dont l’objectif était de développer le contenu d’un questionnaire utilisant l’activation des intentions pour favoriser la consommation de fruits et légumes chez des femmes à risque de développer du diabète gestationnel. L’objectif du quatrième projet de recherche était d’évaluer l’efficacité d’une intervention de type activation des intentions comparativement à un groupe contrôle utilisant l’effet question-comportement pour promouvoir la consommation de fruits et légumes chez des femmes en âge de procréer (18 à 44 ans) à risque de développer du diabète gestationnel. Il s’est avéré que l’activation des intentions et l’effet question-comportement sont des techniques efficaces pour augmenter la consommation de légumes chez des femmes en âge de procréer à risque de développer du diabète gestationnel. Ce résultat suggère que ces deux techniques peuvent être utilisées pour favoriser une alimentation saine avant le début de la grossesse afin de diminuer le risque de développer du diabète gestationnel ou du diabète de type 2 et ainsi assurer la santé de la femme et celle de son enfant. Bref, les quatre projets de recherche de la thèse ont permis de développer une intervention qui utilisait un outil validé pour mesurer la consommation de fruits et légumes, qui répondait aux besoins de la population cible et qui fut efficace pour promouvoir la saine alimentation chez des femmes à risque de développer du diabète gestationnel.The general objective of this thesis is to identify innovative ways to promote healthy eating, that is fruit and vegetable consumption, among women at risk of developing gestational diabetes mellitus. Intervention Mapping was used to guide the development of the intervention. To achieve the thesis’ goal, four distinct, but complementary research projects were conducted. The first research project was a systematic review on the validation of self-reported measures of foods and nutrients in pregnancy. The objective of this review was to identify self-reported measures assessing diet during pregnancy and to critically appraise their psychometric qualities in order to identify which tools should preferably be used among pregnant women. The objective of the second research project was to validate a brief questionnaire on fruit and vegetable consumption among pregnant women. The third project was a formative research whose objective was to develop the content of a questionnaire using implementation intentions to encourage fruit and vegetable intake in women at risk of developing gestational diabetes mellitus. The objective of the fourth research project was to test the efficacy of an implementation intentions intervention compared to a control group based on the question-behavior effect to promote fruit and vegetable consumption among childbearing age (18 to 44 years) women at risk of developing gestational diabetes mellitus. Implementation intentions and the question-behavior effect were effective techniques to increase vegetable consumption among childbearing age women at risk of developing gestational diabetes mellitus. This result suggests that these two techniques can be used to promote healthy eating before the onset of pregnancy to lower risks of developing gestational diabetes mellitus or type 2 diabetes and thus favor the health of the woman and her child. In sum, the thesis’ four research projects allowed the development of an intervention which used a validated tool to measure fruit and vegetable intake, which addressed the target population’s needs and that was effective in promoting healthy eating among women at risk of developing gestational diabetes mellitus

Validity and reliability of self-reported measures of foods and nutrients in pregnancy : a systematic review

This systematic review aims to critically appraise evidence on validity and reliability of self-reported measures of foods and nutrients in pregnancy. PubMed and EMBASE were investigated. Fifty-four studies were included. Food-frequency questionnaires had acceptable evidence of validity when compared with biomarkers (͞r between 0.04 and 0.58; k=19), 24-hour recalls (͞r between 0.12 and 0.63; k=11) and food records: (͞r between 0.28 and 0.65; k=12). Dietary history (͞r between 0.07 and 0.47; k=7) and food records (͞r between 0.25 and 0.53; k=7) had acceptable evidence of validity when compared with biomarkers. 24-hour recalls had poor evidence of validity against biomarkers. Evidence on reliability was good for food-frequency questionnaires, acceptable for the dietary history and inconclusive for 24-hour recalls. The results suggest that food-frequency questionnaires and food records have the strongest evidence of validity when assessing nutrition during pregnancy and more studies are needed to validate 24-hour recalls and the dietary history

Associations among sleep, body mass index, waist circumference and risk of type 2 Diabetes among US childbearing age women : national health and nutrition examination survey

Background. Women of childbearing age (18 to 44 years) present an important group for understanding sleep, but few studies have focused on this population. No study has investigated the associations among sleep, overweight/obesity and risk of type 2 diabetes among childbearing age women in the National Health and Nutrition Examination Survey (NHANES). Methods. Data were from NHANES, 2005-2008. The study population consisted of 18 to 44 year old women. Pregnant women and those diagnosed with sleep disorders were excluded. Sleep duration and quality were self-reported. Body mass index (BMI), waist circumference (WC) measurements and a 2-hour 75 g oral glucose tolerance test (OGTT) were performed by trained NHANES staff. An unadjusted linear regression analysis; a second adjusted for demographics only (partially adjusted model); and a third adjusted for demographics and variables associated with overweight/obesity and diabetes (fully adjusted model) were computed to assess associations among sleep duration/quality and BMI, WC and 2-hour OGTT. Results. Total sample consisted of 2388 childbearing age women. Only sleep duration was significantly associated with BMI and WC in the unadjusted and partially adjusted models, but was no longer significant in the fully adjusted model. Neither sleep duration nor quality were significantly associated with 2-hour OGTT in any of the models. Conclusions. Targeting sleep duration and sleep quality alone would not likely contribute to significantly lower BMI, WC or risk of type 2 diabetes in US childbearing age women. Additional studies, especially longitudinal ones using objective measures of sleep are needed to confirm the present findings

Psychosocial determinants of fruit and vegetable intake in adult population: a systematic review

<p>Abstract</p> <p>Background</p> <p>Accumulating evidence suggests that fruit and vegetable intake (FVI) plays a protective role against major diseases. Despite this protective role and the obesity pandemic context, populations in Western countries usually eat far less than five servings of fruits and vegetables per day. In order to increase the efficiency of interventions, they should be tailored to the most important determinants or mediators of FVI. The objective was to systematically review social cognitive theory-based studies of FVI and to identify its main psychosocial determinants.</p> <p>Methods</p> <p>Published papers were systematically sought using Current Contents (2007-2009) and Medline, Embase, PsycINFO, Proquest and Thesis, as well as Cinhal (1980-2009). Additional studies were identified by a manual search in the bibliographies. Search terms included fruit, vegetable, behaviour, intention, as well as names of specific theories. Only studies predicting FVI or intention to eat fruits and vegetables in the general population and using a social cognitive theory were included. Independent extraction of information was carried out by two persons using predefined data fields, including study quality criteria.</p> <p>Results</p> <p>A total of 23 studies were identified and included, 15 studying only the determinants of FVI, seven studying the determinants of FVI and intention and one studying only the determinants of intention. All pooled analyses were based on random-effects models. The random-effect R²observed for the prediction of FVI was 0.23 and it was 0.34 for the prediction of intention. Multicomponent theoretical frameworks and the theory of planned behaviour (TPB) were most often used. A number of methodological moderators influenced the efficacy of prediction of FVI. The most consistent variables predicting behaviour were habit, motivation and goals, beliefs about capabilities, knowledge and taste; those explaining intention were beliefs about capabilities, beliefs about consequences and perceived social influences.</p> <p>Conclusions</p> <p>Our results suggest that the TPB and social cognitive theory (SCT) are the preferable social cognitive theories to predict behaviour and TPB to explain intention. Efficacy of prediction was nonetheless negatively affected by methodological factors such as the study design and the quality of psychosocial and behavioural measures.</p

Intergenerational effects of health issues among women of childbearing age : a review of the recent literature

Purpose of review. This review summarizes the latest scientific evidence, primarily from systematic reviews/meta-analyses and large cohort studies, on the impact of health issues among women of childbearing age and their effect on their offspring during pregnancy and from birth to adulthood. Recent findings. Women of childbearing age with overweight/obesity, diabetes and hypertension prior to pregnancy are at increased risk for adverse outcomes during pregnancy, such as excessive gestational weight gain, gestational diabetes mellitus and hypertensive disorders of pregnancy. These adverse outcomes could complicate delivery and put their offspring at risk of developing overweight/obesity, diabetes and hypertension (i.e., intergenerational transmission of health issues). Summary. Interventions should target women of childbearing age, especially those who wish to conceive, in order to possibly stop the transmission of women’s health issues to the offspring and favor a healthy pregnancy from the start. This could be one of the best strategies to promote both maternal and child health

Sleep, diet and physical activity among adults living with type 1 and type 2 diabetes

Objective: To document sleep/insomnia, fruit and vegetables (FV) consumption and physical activity (PA) according to diabetes presence and type and biological sex, as these three lifestyle habits may influence glycemic control and prevention of diabetes-related complications. Method: Adults between 18-64 years of age were invited to complete validated Web-based self-reported questionnaires assessing sleep, insomnia, FV consumption and PA. Pregnant women and shift workers were excluded from the study. Results: A total of 151 adults (80.1% women), of which 54 had diabetes (type 1 [T1D]: 30 and type 2 [T2D]: 24), completed the questionnaires. Sleep quality scores were significantly higher, indicating poorer sleep quality, according to diabetes presence (diabetes: 7.2±3.5 vs. no diabetes: 5.4±3.5, p=0.0024) and type (T1D: 6.1±2.9 vs. T2D: 8.7±3.8, p=0.0072). Sleep duration was significantly shorter among adults living with diabetes (diabetes: 7.0±1.7 hours/night vs. no diabetes: 7.8±1.3 hours/night, p=0.0019), regardless of type. More adults living with diabetes had moderate to severe clinical insomnia (diabetes: 25.9% vs. no diabetes: 10.4%, p=0.0129), especially those with T2D (T1D: 13.3% vs. T2D: 41.7%, p = 0.0182). FV consumption and PA did not significantly vary according to diabetes presence and type. Only PA differed by biological sex with lower PA among women. Discussion: The results suggest that adults living with diabetes, especially those with T2D, are at higher risk for short and poor sleep quality, and clinical insomnia. Conclusions: Adults living with diabetes, especially those with T2D, should have access to effective sleep interventions to prevent complications associated with elevated glucose levels.Objectifs L’objectif de nos travaux était de documenter le sommeil et l’insomnie, la consommation de fruits et de légumes (FL) et l’activité physique (AP) en fonction de la présence et du type de diabète, et du sexe biologique, puisque ces 3 habitudes de vie peuvent influencer la régulation de la glycémie et la prévention des complications liées au diabète. Méthodes Nous avons invité des adultes âgés de 18 à 64 ans à remplir des questionnaires valides d’autoévaluation en ligne qui portaient sur le sommeil, l’insomnie, la consommation de FL et l’AP. Nous avons exclu de l’étude les femmes enceintes et les travailleurs de quart. Résultats Un total de 151 adultes (80,1 % de femmes), parmi lesquels 54 avaient le diabète (type 1 [DT1], n = 30; type 2 [DT2], n = 24), ont rempli les questionnaires. Les scores sur la qualité du sommeil étaient significativement plus élevés, c’est-à-dire qu’ils indiquaient une moins bonne qualité de sommeil, en fonction de la présence de diabète (diabète, 7,2 ± 3,5; aucun diabète, 5,4 ± 3,5; p = 0,0024) et du type de diabète (DT1, 6,1 ± 2,9; DT2, 8,7 ± 3,8; p = 0,0072). La durée du sommeil était significativement plus courte chez les adultes qui vivaient avec le diabète (diabète, 7,0 ± 1,7 heures/nuit; aucun diabète, 7,8 ± 1,3 heures/nuit; p = 0,0019), indépendamment du type. Davantage d’adultes qui vivaient avec le diabète avaient une insomnie clinique modérée à importante (diabète, 25,9 %; aucun diabète, 10,4 %; p = 0,0129), particulièrement ceux atteints du DT2 (DT1, 13,3 %; DT2, 41,7 %; p = 0,0182). La consommation de FL et l’AP ne variaient pas de façon significative en fonction de la présence et du type de diabète. Seule l’AP différait selon le sexe biologique, c’est-à-dire une AP moindre chez les femmes. Conclusions Les résultats montrent que les adultes qui vivent avec le diabète, particulièrement le DT2, sont exposés à un risque plus élevé de courte durée de sommeil et de mauvaise qualité de sommeil, et d’insomnie clinique. Les adultes qui vivent avec le diabète, particulièrement ceux qui vivent avec le DT2, devraient avoir accès à des interventions efficaces sur le sommeil pour prévenir les complications associées à une glycémie élevée

Beliefs of adolescents on sugar-sweetened beverages abstinence : a reasoned action approach elicitation study

Introduction. Sugar-sweetened beverage (SSB) consumption is associated with many health problems, such as obesity and cardiovascular diseases. Objectives. To identify adolescents’ beliefs concerning SSB abstinence. Methods. Based on the Reasoned Action Approach, thirty semi-structured interviews were conducted with adolescents (12-17 years). They were selected based on age, sex and setting in order to ensure a broad representation of adolescents from two French-speaking regions of the province of Quebec in Canada (Eastern Canada). Adolescents were invited to answer eight open-ended questions regarding SSB abstinence in the next month. A qualitative content analysis was performed independently by two experts to identify the most important beliefs. Results. According to adolescents, the main advantage of abstaining from SSB was that it would be good for their health and the main disadvantage was that they would have to give up products they liked drinking for the taste. Parents and friends seemed to be the most important social influences regarding abstaining from SSB. Adolescents mentioned many barriers to SSB abstinence, such as contextual barriers (e.g., special occasions, eating out, following sports activities), the presence of SSB drinkers, advertisements promoting SSB, and the urge to drink SSB. Facilitating factors included absence of SSB at home/school, having easy access to water and pure fruit juices, and receiving information about the negative health effects of SSB. Discussion/Conclusions. The results of this preliminary study can be used to guide the development of interventions to promote SSB abstinence among adolescents.Introduction. La consommation de boissons sucrées (BS) est associée à de nombreux problèmes de santé tels que l'obésité et les maladies cardiovasculaires. Objectif. Identifier les croyances des adolescents concernant l'abstinence de consommer des boissons sucrées (ACBS). Méthodes. Fondées sur l'Approche de l'action raisonnée, trente entrevues semi-structurées ont été réalisées avec des adolescents (12-17 ans). La sélection selon l'âge, le sexe et le milieu a permis d'assurer une large représentation d'adolescents de deux régions francophones du Québec (Est du Canada). Suivant la définition des BS, les adolescents ont répondu à huit questions ouvertes au sujet de l'ACBS au cours du mois à venir. Une analyse qualitative de contenu réalisée indépendamment par deux experts a permis d'identifier les croyances les plus importantes. Résultats. Le principal avantage de l'ACBS est le bénéfice pour la santé et le principal désavantage est de ne pas pouvoir boire des produits dont ils aiment le goût. Les parents et les amis semblent les personnes les plus influentes concernant l'ACBS. De nombreux obstacles à l'ACBS ont été identifiés, tels que le contexte (occasions spéciales, au restaurant, après les activités sportives), la présence de personnes qui boivent des BS, les publicités sur les BS et l'envie d'en boire. Les facteurs facilitants comprenaient l'absence de BS à la maison ou à l'école, un accès facile à l'eau et à des jus de fruits purs et l'information sur les conséquences des BS. Discussion/conclusion. Les résultats de cette étude préliminaire peuvent guider le développement d'interventions favorisant l'abstinence de la consommation de BS chez les adolescents