New Zealanders' attitudes to milk : implications for public health

Objective: To identify consumer attitudes and beliefs about (liquid) milk that may be barriers to consumption.

Design: Two random-quota telephone surveys conducted in Auckland one year apart. Respondents were questioned about their usual milk intake and their attitudes to milk. The questionnaire included attitude items that reflected the main themes of consumer interest in milk.

Setting: New Zealand.

Subjects: Seven hundred and thirteen respondents in the baseline survey and a separate sample of 719 respondents in the follow-up survey.

Results: At least one-third of the respondents consumed less than a glass (250ml) of milk a day. Non-consumption was highest in young women (15%). People's concerns about milk related to what was important in their lives; what threatens them physically and emotionally. Women held more positive attitudes but they were concerned about the fat content of milk. Men were less aware of milk's nutritional benefits and as a result were less appreciative of its value.

Conclusions: There is an opportunity to develop public health initiatives to address the barriers to drinking milk. Industry–health alliances may be an effective means to provide positive nutrition messages about milk and to engage the support of health professionals.

Australian consumers' food-related environmental beliefs and behaviours

The aim of this study was to examine Australians’ food-related environmental beliefs and behaviours. Questionnaires were posted to 500 randomly selected adults, with 223 questionnaires completed (58% response rate). Decreased use of packaging by food manufacturers was viewed as being the most important item to help the environment, while lower meat consumption was seen as least likely to help. Composting food scraps and purchase or consumption of locally produced foods were the most commonly performed food-related environmental behaviours, while use of organic products was the least commonly performed. Moderate consistency (r_s=0.54) was found between reported beliefs and behaviours. Older people were more likely to perform certain food-related environmental behaviours, such as composting. Awareness of the impact on the environment of meat production, organic compared to conventional farming, and food packaging was low even among those who were found to already believe that food-related actions are important to help the environment, suggesting widespread consciousness raising is needed.

The utility of the Mood Disorders Questionnaire as a screening tool in a methadone maintenance treatment program

Objective. Comorbid mental illness amongst methadone maintenance therapy clients may be common and screening may be warranted. The Mood Disorders Questionnaire (MDQ) is a screening tool for bipolar disorder that has been validated in other treatment settings. Its utility for patients with substance use disorders is assessed in this study.

Methods. Clients of a methadone maintenance program were invited to complete the MDQ when they attended a public Drug and Alcohol Service for their regular scheduled appointments. Information about their history of substance use was also collected.

Results. Eighty clients (43 females, 37 males) aged 35 8.0 years (mean SD) participated in the study. Seventy-four clients completed the MDQ of which 36 (48.6%) obtained a positive screen. A check of client fi les suggested that only three of the 74 participants had a current working diagnosis of bipolar disorder. These three participants had screened positive on the MDQ.

Conclusions. There was a high prevalence of manic symptoms reported by participants, suggesting that screening for bipolar disorder in this population may be warranted. However, there is a risk of false positives with the MDQ, as it does not clearly differentiate between symptoms of mania and drug intoxication.

Pilot Study of clinician attitudes to insulin pump therapy: international differences and the need for a greater understanding of the patient perspective

OBJECTIVES: To identify and survey health care professionals (HCPs) attitudes to insulin pump therapy (CSII).

METHODS: Eight specialists were interviewed to explore the attitudes and beliefs about CSII. Responses were analysed thematically and used to inform the design of a new 22-item questionnaire: the Attitudes to Pump Therapy (APT) Survey. The APT was pilottested among 95 HCPs (54% male; 75.5% diabetologists/DSNs, 13.8% general practitioners) at the International Diabetes Federation (IDF) conference, 2006. Results were analysed using non-parametric statistics with bonferroni correction.

RESULTS: Analyses of interview data identified 9 themes: biomedical, perceived control of care/diabetes, technology, quality of life, financial resources, training, education & support, suitability, and evidence-base. Items were designed to reflect these themes with responses scored on a 5-point Likert scale (strongly agree—strongly disagree). No statistically significant differences
were found by gender, HCP speciality, country (and continent) of origin or proportion of patients using CSII. Most notable differences were found in relation to gross domestic product (GDP) and the potential for pump therapy to achieve tight blood glucose control (lower GDP = more agreement: p = 0.001), and result in diabetic ketoacidosis (DKA) (lower GDP = less agreement: p < 0.005). Ranked mean scores showed a split between biomedical/clinical items (N = 11) and items concerned with patient experience (N = 11). Attitudes about biomedical/clinical issues were generally clear (i.e. for 7/11 items, the mean score was “agree”) but less decisive about patient experience (i.e. for 8/11 items, the mean score was “neither agree nor disagree”).

CONCLUSION: Few subgroup differences existed, but those that did may be explained by lack of access to treatment (directly corresponding to GDP). Clinicians’ were generally clear in their attitudes regarding biomedical aspects but less so regarding patient experience. Research focusing on patient-reported outcomes is likely to offer clinicians a greater understanding of the patients’ perspective of insulin pump therapy.

The Renal Treatment Satisfaction Questionnaire (RTSQ): a measure of satisfaction with treatment for chronic kidney failure.

BACKGROUND: Quality and effectiveness of care can be enhanced through the use of condition-specific measures of satisfaction with treatment. The aim of the present study was to design and develop a measure of satisfaction with treatment for patients with chronic kidney failure (CKF) for use in routine clinical care and clinical trials. The Renal Treatment Satisfaction Questionnaire (RTSQ) was designed to be suitable for people using any of the various treatment modalities for CKF. Items measure satisfaction with aspects of treatment, including convenience, flexibility, freedom, and satisfaction to continue with present form of treatment.

METHODS: A 12-item RTSQ was investigated at a UK hospital-based renal unit, using data from 140 outpatients undergoing renal replacement therapy (hemodialysis, n = 35; continuous ambulatory peritoneal dialysis, n = 57; transplantation, n = 46).

RESULTS: An 11-item scale was developed from the original 12-item version, with a single factor accounting for 59% of the variance and item loadings greater than 0.58. Scale reliability was excellent (alpha = 0.93) in the full sample and proved robust to analysis in separate treatment subgroups. As expected, RTSQ scores differed significantly ( P < 0.0001) between the transplantation and other treatment groups. Those who had received a transplant expressed greater overall satisfaction, with specific advantages of transplantation shown by all individual items, including convenience, time, lifestyle, freedom, and satisfaction to continue current treatment.

CONCLUSION: The RTSQ provides a brief reliable measure of satisfaction with treatment for patients with CKF that is suitable for use in routine clinical care and clinical trials.

Health beliefs - what role do they play in outcomes research?

Lay beliefs about health and illness are individual and social, influenced by prevailing social and medical ideologies. Health beliefs clearly influence self-care motivation and have an effect on health-promoting behaviour (e.g. attendance at a screening program, food choices, adherence to prescribed medication). Further, the beliefs and attributions that people hold can directly affect physiological systems (e.g. the immune system). Health beliefs have been shown to influence a variety of patient-reported outcomes, including medication adherence, satisfaction and health-related quality of life. It is widely acknowledged that when the patient's beliefs are acknowledged and incorporated, rather than ignored, optimal biomedical patient-reported outcomes are more likely to be achieved. Several psychological models have been developed to predict health behaviours and may be utilised to identify the beliefs that inform such behaviours. These models consider the social milieu, personality, demographic, political and economic predictors of health beliefs. They demonstrate the impact of beliefs such as the causes of illness, effectiveness of healthcare and acceptability of health services, and how manipulating these can result in actual or intended behaviour change. This workshop will introduce health beliefs and discuss the psychological models that underpin the translation of belief into behaviour. The session is interactive, with participants defining health beliefs and their impact on behaviour. Participants will be invited to critique the models and apply their chosen model to a health indication of their choice.

Reliability of the modified child and adolescent physical activity and nutrition survey, physical activity (CAPANS-PA) questionnaire among chinese-australian youth

Background : Evidence suggests that differences exist in physical activity (PA) participation among Culturally and Linguistically Diverse (CALD) children and adolescents. It is possible that these differences could be influenced by variations in measurement technique and instrument reliability. However, culturally sensitive instruments for examining PA behaviour among CALD populations are lacking. This study tested the reliability of the Child and Adolescent Physical Activity and Nutrition Survey (CAPANS-PA) recall questionnaire among a sample of Chinese-Australian youth.
Methods : The psychometric property of the CAPANS-PA questionnaire was examined among a sample of 77 Chinese-Australian youth (aged 11 - 14 y) who completed the questionnaire twice within 7 days. Test-retest reliability of individual items and scales within the CAPANS-PA questionnaire was determined using Kappa statistics for categorical variables and intraclass correlation coefficients (ICC) for continuous variables.
Results : The CAPANS-PA questionnaire demonstrated acceptable test-retest reliability for frequency and duration of time spent in weekly Moderate to Vigorous Physical Activity (MVPA) (ICC ≥ 0.70) for all participants. Test-retest reliability for time spent in weekly sedentary activities was acceptable for females (ICC = 0.82) and males (ICC = 0.72).
Conclusions : The results suggest the CAPANS-PA questionnaire provides reliable estimates for type, frequency and duration of MVPA participation among Chinese-Australian youth. Further investigation into the reliability of the sedentary items within the CAPANS-PA is required before these items can be used with confidence. This study is novel in that the reliability of instruments among CALD groups nationally and internationally remains sparse and this study contributes to the wider body of available psychometrically tested instruments. In addition, this study is the first to our knowledge to successfully engage and investigate the basic health enhancing behaviours of Chinese-Australian adolescents.

Managing depression in patients with vision impairment : a descriptive study of practitioners' beliefs and confidence

Aim: Depression is common in older adults with vision impairment yet it often remains unidentified and untreated.
Eye health professionals (EHPs) and rehabilitation workers (RWs) may be able to assist in detecting depression. This study identified EHPs’ and RWs’ beliefs about depression and confidence in working with patients with vision
impairment and depression.
Methods: A self-administered cross-sectional survey of 94 EHPs and RWs assessed beliefs about the symptoms and treatment for depression, and confidence in working with depressed people with vision impairment.
Results: Participants showed awareness of both the symptoms and treatment options for depression. However,
some important misconceptions were identified and many symptoms of depression were commonly attributed to
vision loss. Participants lacked confidence in communicating about depression with patients and their families.
Conclusions: Training programs are needed to enable EHPs and RWs to confidently identify depression and
discuss appropriate treatment and referral options with their patients.

Interparent agreement on the strengths and difficulties questionnaire : a Chinese study

This article reports on the first study to investigate interparent agreement when the Strengths and Difficulties Questionnaire (SDQ) is used to assess school-aged children. It is also the first study conducted in China on agreement between parents reporting on their child. Both parents of 380 girls and 320 boys completed the Strengths and Difficulties Questionnaire (Chinese version). Because reliabilities were poor, the Conduct Problems and Hyperactivity=Inattention subscales were merged to form an Externalizing Problems subscale, and the Peer Problems subscale as an independent variable was omitted from analyses. Consistent with past research, moderate to strong correlations were found between mother and father reports for emotional and behavioral problems, although interparent agreement was better for externalizing problems than internalizing problems for both girls and boys. Mothers reported significantly higher scores than fathers for prosocial behaviors for their sons. Findings suggest that, in general, one parent’s report will be similar to the other’s when the SDQ is used in the form adapted for this study. More work on the psychometric properties of the SDQ is needed in China.

Exploring negativity bias in brand beliefs and stated brand switching propensity

Negativity bias has been well studied by psychologists but limited research has been conducted on it in a marketing context. Given previous research, this exploratory study aims to examine whether there are any negativity bias effects in brand beliefs and whether there is any influence on stated brand switching propensity amongst current users of a brand. The results suggest that there is a negativity bias evident in brand image data.