Website physical activity interventions: preferences of potential users

Information and communication technologies (particularly websites and e-mail) have the potential to deliver health behavior change programs to large numbers of adults at low cost. Controlled trials using these new media to promote physical activity have produced mixed results. User-centered development methods can assist in understanding the preferences of potential participants for website functions and content, and may lead to more effective programs. Eight focus group discussions were conducted with 40 adults after they had accessed a previously trialed physical activity website. The discussions were audio taped, transcribed and interpreted using a themed analysis method. Four key themes emerged: structure, interactivity, environmental context and content. Preferences were expressed for websites that include simple interactive features, together with information on local community activity opportunities. Particular suggestions included online community notice boards, personalized progress charts, e-mail access to expert advice and access to information on specific local physical activity facilities and services. Website physical activity interventions could usefully include personally relevant interactive and environmentally focused features and services identified through a user-centered development process.

Predictors of men's acceptance of modern contraceptive practice: Study in rural Vietnam

Studies have shown family planning adoption is likely to be more effective for women when men are actively involved. The transtheoretical model of behavior change was used to examine men's involvement in general contraception and intrauterine device (IUD) use by their wives. The study was carried out in rural Vietnam with 651 eligible participants. Cons of IUD use for men in precontemplation and contemplation/preparation were significantly higher than those in the action/maintenance stages, whereas the reverse was true for pros of IUD. The self-efficacy for convincing wife to have IUD in precontemplation was significantly lower than for those in higher stages. Women's education and ages, spontaneous recall of modem contraceptive method, cons for IUD, and self-efficacy for contraception and for convincing wives to get IUD inserted (or continue use) were significant predictors of men's readiness to accept IUD. Interventions are targeted to reduce cons and increase self-efficacy for IUD use.

Small-scale randomized controlled trials need more powerful methods of mediational analysis than the Baron-Kenny method

Objective: To devise more-effective physical activity interventions, the mediating mechanisms yielding behavioral change need to be identified. The Baron-Kenny method is most commonly used. but has low statistical power and May not identify mechanisms of behavioral change in small-to-medium size Studies. More powerful statistical tests are available, Study Design and Setting: Inactive adults (N = 52) were randomized to either a print or a print-plus-telephone intervention. Walking and exercise-related social support Were assessed at baseline, after file intervention, and 4 weeks later. The Baron-Kenny and three alternative methods of mediational analysis (Freedman-Schatzkin; MacKinnon et al.: bootstrap method) were used to examine the effects of social support on initial behavior change and maintenance. Results: A significant mediational effect of social support on initial behavior change was indicated by the MacKinnon et al., bootstrap. and. marginally. Freedman-Schatzkin methods, but not by the Baron-Kenny method. No significant mediational effecl of social support on maintenance of walking was found. Conclusions: Methodologically rigorous intervention studies to identify mediators of change in physical activity are costly and labor intensive, and may not be feasible with large samples. The Use of statistically powerful tests of mediational effects in small-scale studies can inform the development of more effective interventions. (C) 2006 Elsevier Inc. All rights reserved.

The association between number of homework assignments completed during a lifestyle physical activity intervention and scores on transtheoretical measures

An assumption of theory-based physical activity interventions is that active participation positively affects the theoretical constructs upon which the intervention is based. This assumption is rarely tested. This study assessed whether participation, defined as completion of homework, in a lifestyle physical activity intervention was associated with changes over 6 months in constructs the homework addressed: the behavioral and cognitive processes of change, self-efficacy, and decisional balance (the pros and cons). Participants were 244 sedentary adults aged 25 to 75 years. They completed an average of 12 of 20 homework assignments. Those completing at least two-thirds of the homework (n = 113) had greater changes in the theoretical constructs from pretest to posttest than those completing less (n = 90). Post-hoc analyses suggest that completing theory-based homework may impact the processes of change and self-efficacy in lifestyle physical activity interventions and, therefore, are warranted in future interventions.

Using epidemiological models to estimate the health effects of diet behaviour change: the example of tailored fruit and vegetable promotion

Objective: To explore the use of epidemiological modelling for the estimation of health effects of behaviour change interventions, using the example of computer-tailored nutrition education aimed at fruit and vegetable consumption in The Netherlands. Design: The effects of the intervention on changes in consumption were obtained from an earlier evaluation study. The effect on health outcomes was estimated using an epidemiological multi-state life table model. input data for the model consisted of relative risk estimates for cardiovascular disease and cancers, data on disease occurrence and mortality, and survey data on the consumption of fruits and vegetables. Results: if the computer-tailored nutrition education reached the entire adult population and the effects were sustained, it could result in a mortality decrease of 0.4 to 0.7% and save 72 to 115 life-years per 100000 persons aged 25 years or older. Healthy life expectancy is estimated to increase by 32.7 days for men and 25.3 days for women. The true effect is likely to lie between this theoretical maximum and zero effect, depending mostly on durability of behaviour change and reach of the intervention. Conclusion: Epidemiological models can be used to estimate the health impact of health promotion interventions.

Engagement and retention of participants in a physical activity website

Background. Websites have the potential to deliver enhanced versions of targeted and tailored physical activity programs to large numbers of participants. We describe participant engagement and retention with a stage-based physical activity website in a workplace setting. Methods. We analyzed data from participants in the website condition of a randomized trial designed to test the efficacy of a print- vs. website-delivered intervention. They received four stage-targeted e-mails over 8 weeks, with hyperlinks to the website. Both objective and self-reported website use data were collected and analyzed. Results. Overall, 327 were randomized to the website condition and 250 (76%) completed the follow-up survey. Forty-six percent (n = 152) visited the website over the trial period. A total of 4,114 hits to the website were recorded. Participants who entered the site spent on average 9 min per visit and viewed 18 pages. Website use declined over time; 77% of all visits followed the first e-mail. Conclusions. Limited website engagement, despite the perceived usefulness of the materials, demonstrates possible constraints on the use of e-mails and websites in delivering health behavior change programs. In the often-cluttered information environment of workplaces, issues of engagement and retention in website-delivered programs require attention. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.

Prospective study of individual, social, and environmental predictors of physical activity: women's leisure running

Background: Understanding and influencing the determinants of physical activity is an important public health challenge. We used prospective data to examine the influence of individual, social, and environmental factors on physical activity behaviour, using regular running as the behavioural model. Methods: Over 500 middle-aged women completed two consecutive questionnaires in 2000 and 2002. Logistic regression analyses were used to examine factors predicting adoption of and regression from regular leisure-time running during the follow-up. Results: Women who frequently used behavioural change skills were more likely to adopt regular running (OR=4.0, CI=1.7-9.5). There was an interaction between the enjoyment of running and family support: those who rated enjoyment of running high and reported high family support were less likely to adopt running (OR= 0.2, CI = 0.1-0.5). Women who reported infrequent use of motives were more likely (OR = 3.3, CI = 1.6-6.9) to regress from regular running. There was an interaction between perceived health and the neighbourhood environment: those who perceived themselves to be in poor health and had an unattractive neighbourhood were more likely (OR = 2.7, CI = 0.9-8.3) to regress from regular running. Conclusions: Behavioural skills and enjoyment may be of particular importance for the adoption of regular activity; social support and an aesthetically attractive neighbourhood are likely to have a key role in encouraging maintenance. (c) 2004 Elsevier Ltd. All rights reserved.

Cognitive change processes in a group cognitive behavior therapy of depression

The present study attempted to examine the causal relationships among changes in automatic thoughts, dysfunctional attitudes, and depressive symptoms in a 12-week group cognitive behavior therapy (GCBT) program for depression. In all, 35 depressed patients attending the GCBT program were monitored with the Automatic Thoughts Questionnaire, Dysfunctional Attitudes Scale, and Beck Depression Inventory at the pre-treatment, 4th and 8th sessions, and post-treatment. The results were as follows: (1) GCBT reduces negative cognitions; (2) changes in automatic thoughts and dysfunctional attitudes lead to change in depressive symptoms; and (3) automatic thoughts play a mediating role between dysfunctional attitudes and depression. The findings taken as a whole support the Causal Cognition Model of depression. (C) 2003 Elsevier Science Ltd. All rights reserved.

Dimensional change behavior of caribbean pine using an environmental scanning electron microscope

Moisture transport and dimensional change during wood drying or wetting processes were analyzed based on pictures from an environmental scanning electron microscope (ESEM). This provides quantitative relationships between dimensional changes of total area, cell wall, and lumen, and moisture content for earlywood and latewood. Earlywood and latewood behave similarly but show some quantitative differences. The overall outcome for sections containing both kinds of wood seems to be dominated by the latewood behavior. The observed strain behavior of wood during drying is anisotropic in ways that are inconsistent with explanations solely related to microfibril orientation or earlywood/latewood interactions and more likely may be influenced by ray tracheids.

Protective Eyewear Promotion: Applying Principles of Behaviour Change in the Design of a Squash Injury Prevention Programme

Eye injuries in squash have the potential to be severe. Although these injuries can be prevented through the use of protective eyewear, few players wear such eyewear. The aim of this paper is, to outline the behavioural principles guiding the design of a squash eyewear promotion initiative, the Protective Eyewear Promotion (PEP). Ecological principles of behaviour change were used to provide a comprehensive perspective on intrapersonal factors, policies and physical environmental influences of protective eyewear use. Results of baseline player surveys and venue manager inter-views were used to provide relevant and specific intervention content. At baseline, protective eyewear was not found to be readily available, and players' behaviours, knowledge and attitudes did not favour its use. The main components of PEP involved informing and educating both players and squash venue operators of the risk of eye injury and of appropriate protective eyewear, as well as assisting with the availability of the eyewear and offering incentives for players to use it. A structural strength of PEP was the strong collaborative links with the researchers of different disciplines, the squash governing body, eyewear manufacturers, squash venue personnel, as well as players. Attempts were made within the project structure to make provision for the future dissemination and sustainability of more widespread eye injury prevention measures in the sport of squash.

Injury and risk-taking behavior - a systematic review

There is a substantial body of work in the scientific literature discussing the role of risk-taking behavior in the causation of injury. Despite the quantity of diverse writings on the subject most is in the form of theoretical commentaries. This review was conducted to critically assess the empirical evidence supporting the association between injury and risk-taking behavior. The review found six case-control studies and one retrospective cohort study, which met all the inclusion criteria. Meta-analysis was not possible due to the diversity of the independent and outcome variables in each of the studies reviewed. Overall the review found that risk-taking behavior, however it is measured, is associated with an increased chance of sustaining an injury except in the case of high skilled, risk-taking sports where the effect may be in the other direction. Drawing specific conclusions from the research presented in this review is difficult without an agreed conceptual framework for examining risk-taking behavior and injury. Considerable work needs to be done to provide a convincing evidence base on which to build public health interventions around risk behavior. However, sufficient evidence exists to suggest that effort in this area may be beneficial for the health of the community. (C) 2003 Elsevier Science Ltd. All rights reserved.

Crystalloid strong ion difference determines metabolic acid-base change during acute normovolaemic haemodilution

Objective. To study the acid-base effects of crystalloid strong ion difference (SID) during haemodilution. Design. Prospective in vivo study. Setting. University laboratory. Subjects. Anaesthetised, mechanically ventilated Sprague-Dawley rats. Interventions. Rats were studied in seven groups of three. Each group underwent normovolaemic haemodilution with one of seven crystalloids, with SID values from 0 to 40 mEq/l. Six exchanges of 9 ml crystalloid for 3 ml blood were performed. Measurements and main results. [Hb] fell from 142+/-17 to 44+/-10 g/l (p

The role of psychological climate in facilitating employee adjustment during organizational change

The current research tested a theoretical model of employee adjustment during organizational change based on Lazarus and Folkman's (1984) cognitive-phenomenological framework. The model hypothesized that psychological climate variables would act as coping resources and predict improved adjustment during change. Two variations of this model were tested using survey data from two different organizational samples: 779 public hospital employees and 877 public sector employees. Confirmatory factor analyses and structural equation analyses were conducted in order to evaluate the models. Results showed that employees whose perceptions of the organization and environment in which they were working (that is, psychological climate) were more positive, were more likely to appraise change favourably and report better adjustment in terms of higher job satisfaction, psychological well-being, and organizational commitment, and lower absenteeism and turnover intentions.

Effect of Australia's walk to work day campaign on adults' active commuting and physical activity behavior

Purpose. To determine whether Australia's Walk to Work Day media campaign resulted in behavioural change among targeted groups. Methods. Pre- and postcampaign telephone surveys of a cohort of adults aged 18 to 65 years (n = 1100, 55% response rate) were randomly sampled from Australian major melropolitan areas. Tests for dependent samples were applied (McNemax chi(2) or paired t-test). Results. Among participants who did not usually actively commute to work was a significant decrease in car only use an increase in walking combined with public transport. Among those who were employed was a significant increase in total time walking (+16 min/wk; t [780] = 2.04, p < .05) and in other moderate physical activity (+120 min/wk; t [1087] = 4.76, p < .005), resulting in a significant decrease in the proportion who were inactive (chi(2) (1) = 6.1, p < .05). Conclusion. Although nonexperimental, the Walk to Work Day initiative elicited short-term changes in targeted behaviors among target groups. Reinforcement by integrating worksite health promotion strategies may be required for sustained effects.