ORCID Profile
0000-0002-0801-498X
Current Organisation
University of Bremen
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Publisher: Wiley
Date: 17-05-2022
DOI: 10.1111/APHW.12368
Abstract: Subjectively prioritizing health over other life domains is an indicator of health motivation and is associated with higher levels of health behaviors and more effective health behavior self‐regulation. However, little is known about when in iduals prioritize health over other life domains and which factors predict prioritizing health. Here, we examine 3644 older adults in Germany (mean age 60.79) over a period of 6–9 years from DEAS, a population‐representative survey. Latent growth curves were estimated to examine in idual change in prioritizing health. Socio‐structural (gender, educational attainment) and indicators of health status (baseline status and change in [a] number of illnesses, [b] functional health, and [c] self‐rated health) were tested as predictors of changes in health prioritization. Participants prioritized health over other life domains, and this increased over time. Women and those with worse health status (lower functional and lower self‐rated health) prioritized health more than men and those with better health status, respectively. Lower educational attainment was associated with higher increases in prioritizing health, and interactions between educational status and health indicators show that increases are larger in those with worse health and lower educational attainment. This indicates in idual differences in the degree and the changes of prioritizing health.
Publisher: JMIR Publications Inc.
Date: 24-08-2023
DOI: 10.2196/45583
Abstract: Health-related misinformation on social media is a key challenge to effective and timely public health responses. Existing mitigation measures include flagging misinformation or providing links to correct information, but they have not yet targeted social processes. Current approaches focus on increasing scrutiny, providing corrections to misinformation (debunking), or alerting users prospectively about future misinformation (prebunking and inoculation). Here, we provide a test of a complementary strategy that focuses on the social processes inherent in social media use, in particular, social reinforcement, social identity, and injunctive norms. This study aimed to examine whether providing balanced social reference cues (ie, cues that provide information on users sharing and, more importantly, not sharing specific content) in addition to flagging COVID-19–related misinformation leads to reductions in sharing behavior and improvement in overall sharing quality. A total of 3 field experiments were conducted on Twitter’s native social media feed (via a newly developed browser extension). Participants’ feed was augmented to include misleading and control information, resulting in 4 groups: no-information control, Twitter’s own misinformation warning (misinformation flag), social cue only, and combined misinformation flag and social cue. We tracked the content shared or liked by participants. Participants were provided with social information by referencing either their personal network on Twitter or all Twitter users. A total of 1424 Twitter users participated in 3 studies (n=824, n=322, and n=278). Across all 3 studies, we found that social cues that reference users’ personal network combined with a misinformation flag reduced the sharing of misleading but not control information and improved overall sharing quality. We show that this improvement could be driven by a change in injunctive social norms (study 2) but not social identity (study 3). Social reference cues combined with misinformation flags can significantly and meaningfully reduce the amount of COVID-19–related misinformation shared and improve overall sharing quality. They are a feasible and scalable way to effectively curb the sharing of COVID-19–related misinformation on social media.
Publisher: Hogrefe Publishing Group
Date: 04-2006
DOI: 10.1026/0943-8149.14.2.64
Abstract: Zusammenfassung. Die Vorhersage von Gesundheitsverhalten kann dadurch verbessert werden, dass man neben Intentionen Ausführungsplanung berücksichtigt. Wie gut sich die Planung auf das Verhalten auswirkt, kann aber auch davon abhängen, ob negative Emotionen vorherrschen, z.B. wenn Personen ängstlich erregt sind. Ob solche Effekte bei der regelmäßigen Benutzung von Zahnseide auftreten, wird hier untersucht. In einer Studie mit drei Messzeitpunkten im Abstand von sechs Wochen wurden 157 Teilnehmer zu Interdentalhygiene, Intentionen, Ausführungsplanung und negativen prospektiven Emotionen (Dentalangst und Furcht vor Verletzungen) befragt. Zusätzlich wurde zum zweiten Messzeitpunkt ein objektives Maß für Verhalten (Residualzahnseide) erhoben. Die Ergebnisse von hierarchischen Regressionsanalysen - die getrennt für die Gruppen der hochängstlichen und der niedrigängstlichen Personen gerechnet wurden - zeigen, dass die Effekte der Ausführungsplanung von negativen Emotionen abhängen. Teilnehmer, die mehr Furcht vor Verletzungen verspürten, profitierten weniger von Ausführungsplanung als Teilnehmer, die wenig Furcht berichteten. Vorschläge für einfach durchzuführende Planungsinterventionen und für weitere Forschung werden diskutiert.
Publisher: Springer Science and Business Media LLC
Date: 07-2011
DOI: 10.1007/S10865-011-9368-Y
Abstract: Particularly in older adults, self-reports of physical health need not necessarily reflect their objective health status as they can be biased by optimism. In this study, we examine whether the effect of objective physical functioning on subjective physical functioning is modified by health-specific optimism and self-efficacy. A longitudinal study with three measurement points over 6 months and 309 older adults (aged 65-85) with multimorbidity was conducted. Subjective physical functioning was regressed on objective physical functioning, health-specific optimism and self-efficacy. Subjective physical functioning was predicted by both objective physical functioning and optimism as a mediator. Moreover, an interaction between optimism and self-efficacy was found: Optimism predicted subjective physical functioning only for in iduals with low self-efficacy. Subjective physical functioning is as much based on objective physical functioning as it is on health-specific optimism. Older adults base their subjective physical functioning on objective indicators but also on optimism, when they are less self-efficacious.
Publisher: Springer Science and Business Media LLC
Date: 11-2006
DOI: 10.1007/S00482-006-0475-6
Abstract: Stress is an etiologic factor of pain-relevant craniomandibular disorders (CMD). Interin idual differences in coping with stress and their relation to CMD have rarely been examined. A total of 72 volunteers (20 men, 52 women) were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders. Stress parameters and coping skills were assessed by questionnaires. Stress and one coping factor are correlated with CMD indices. Linear regression analysis found the Life Event Score and cognitive coping by changing appraisals to significantly predict CMD. Stress and coping skills are independent predictors of CMD.
Publisher: Center for Open Science
Date: 25-01-2023
Abstract: Background: Behavioural non-pharmaceutical interventions (NPIs) such as social distancing and hygiene (masking, hand hygiene) were implemented widely during the COVID-19 pandemic to control infections. NPI adherence is crucial for effectiveness, but has also been implied in an increase in mental health problems. However, existing studies often have designs unsuited to understanding mechanistic relationships between NPI adherence, mental health symptoms, and health-related cognitions (risk perceptions, control beliefs). Understanding these mechanisms is crucial for the refinement of existing and the designs of effective future NPIs.Purpose: To separate between- and temporal within-person associations between mental health, risk cognitions and NPI adherence.Methods: Six-month ecological momentary assessment study with six 4-day assessment bouts in 397 German adults. Daily measurement of adherence, mental health symptoms and cognitions during bouts. We used dynamic temporal network analysis to estimate between- person, as well as contemporaneous and temporal within-person effects for distancing and hygiene NPIs.Results: Distinct networks of mental health, health cognitions and adherence emerged. Participants with higher control and higher susceptibility were also more adherent. Similar within-person contemporaneous patterns additionally, distancing and loneliness were associated. Temporally, better adherence to NPIs was associated with better mental health on subsequent days, whereas higher loneliness was associated with better subsequent hygiene adherence.Conclusion: Findings suggest no negative impact of NPI adherence on mental health or vice versa, but instead suggest that adherence might improve mental health symptoms. Control beliefs and risk perceptions are important covariates of adherence - both on between-person and within-person level.
Publisher: Queensland University of Technology
Date: 20-10-2020
DOI: 10.5204/SSJ.1677
Abstract: This research explored whether academic self-efficacy calibration (the match between self-efficacy beliefs and academic outcomes) in first-year psychology students (n=197) differed as a function of task type (written assignment/multiple-choice exam), domain specificity (task level/subject level), over time (mid-semester/end of semester) and according to student achievement level (high achievers/low achievers). Lower-achieving students were overconfident across both the written assignment and the exam, while higher-achieving students were accurately calibrated on both tasks. The subject-level calibration of lower-achieving students improved between mid-semester and the end of semester (though students remained overconfident). Higher-achieving students’ subject-level calibration remained stable over the semester, and they were about half as overconfident as the lower-achieving students. Both groups of students were more overconfident at subject-level than at task-level overall. On the whole, overconfidence was prevalent, especially for low achievers, and at subject level. Findings suggest that a one-size-fits-all approach to self-efficacy is unlikely to be beneficial for all learners.
Publisher: Wiley
Date: 09-2008
Publisher: Wiley
Date: 29-01-2009
Publisher: Springer Science and Business Media LLC
Date: 03-07-2021
DOI: 10.1186/S11556-021-00268-8
Abstract: There are substantial socioeconomic status (SES) differences in sports activity (SA) during the transition to retirement. In line with social-ecological models, the aim of this longitudinal study was to examine the association of perceptions of social and physical neighborhood factors with changes in SA across the retirement transition and to examine potential interactions with SES factors. Data from 6 waves of the German Ageing Survey (DEAS) provided 710 participants (at baseline: mean age 61.1, 52.9% of men) who retired between baseline (1996, 2002, 2008, 2011) and their 6-year follow-up assessment. Associations between changes in SA (increases and decreases compared to retaining) and in idual SES and neighborhood factors were estimated using multinomial logistic regression analysis. Increases were observed in 18.45% of participants, decreases in 10%. Occupational prestige was a risk factor for decreases, education a resource for increases in SA. Interactions between household income and several neighborhood factors were observed. In line with social-ecological models, in idual, neighborhood factors and interacting associations were found. In particular safety perceptions could be a resource for promotion SA in older adults who experience disadvantage.
Publisher: Informa UK Limited
Date: 2012
DOI: 10.1080/08870446.2010.541908
Abstract: The Common-Sense Model assumes that in iduals form subjective representations about their illnesses, which in turn guide cognitive and behavioural responses. This assumption is complicated in in iduals with multimorbidity, and it is an open question to which degree illness-specific and person-level factors determine the representations of specific illnesses. This study examines the structure and interrelations of illness representations in multimorbidity employing a hierarchical framework based on Cognitive Theory. Multiple illness representations were assessed in 305 people aged 65 and older using two Brief Illness Perception Questionnaires. Multilevel modelling was used to explore the relations between illness representations and to explain how two illness-specific representations--personal control and treatment control--were determined by a person-level factor, self-efficacy. Self-efficacy had significant main (B = 0.29 p < 0.01 for personal control B = 0.19 p < 0.05 for treatment control) and interaction effects (B = 0.38 p < 0.01 personal control on self-efficacy × timeline B = -0.31 p < 0.05 treatment control on self-efficacy × coherence). This study suggests that illness-specific representations of older people with multimorbidity are a product of both illness-specific and person-level factors, such as self-efficacy. Strengthening in idual self-efficacy may improve illness controllability regardless and on top of illness-specific information.
Publisher: Center for Open Science
Date: 21-12-2022
Abstract: Objectives: Adhering to behavioral recommendations and non-pharmaceutical interventions (NPIs) is key to control COVID-19 infection rates. However, rates have decreased globally, and potentially modifiable determinants of ongoing adherence and their interaction with social and physical momentary environments are still poorly understood. Here, we comprehensively examine within-person variations and between-person differences in known behavioral determinants (capability, motivation), as well as the moderating role of situationally variable environmental factors (opportunity) in predicting adherence to hygiene and social distancing behaviors. Methods: Ecological momentary assessment study over six months with monthly assessment bouts (four days each, five daily assessments) in 623 German adults. Repeated daily assessments of Capability-Opportunity-Motivation model of behavior (COM-B) factors. Bayesian multilevel logistic regression models were estimated to examine main effects of COM-B factors and moderating effects of momentary environmental factors. Results: Momentary adherence to NPIs was predicted by within-person changes in COM-B factors (motivation: intentions, goal conflict, control beliefs opportunities: regulations, norms). Between-person differences in capabilities (habit strength) and motivation (intentions, control beliefs) predicted adherence across situations. Situation-specific environmental factors moderated the motivation-behavior association (regulation measures increased goal conflict, and non-adherent others decreased the association). Conclusions: In idual momentary (within-person) and stable (between-person) motivation indicators predicted adherence. However, situational environmental factors such as regulations or norms have strong main effects and moderate the motivation-behavior translation. These findings have policy implications, supporting recent claims to not rely on the narrative of “personal responsibility”, but instead combine health education measures to increase in idual motivation with consistent regulation.
Publisher: Wiley
Date: 09-2008
Publisher: Informa UK Limited
Date: 19-05-2009
DOI: 10.1080/08870440902939857
Abstract: This study examines age-differential association patterns between intentions, planning and physical activity in young and middle-aged in iduals. The effectiveness of planning to bridge the intention-behaviour gap is assumed to increase with advancing age. We explore the use of behaviour change strategies that include selection, optimisation and compensation (SOC) as underlying mechanisms for age differences. In N = 265 employees of a national railway company (aged 19-64 years), intentions, planning, SOC strategy use and physical activity were assessed at baseline (Time 1) and again 1 month later (Time 2). Hypotheses were tested in two different path models. Age moderates the extent to which planning mediates the intention-behaviour relation due to an increasing strength of the planning-behaviour link. As a possible psychological mechanism for these age differences, we identified SOC strategy use as a mediator of the age by planning interaction effect on physical activity. These findings suggest differential mechanisms in behaviour regulation in young and middle-aged in iduals.
Publisher: Springer Science and Business Media LLC
Date: 12-10-2019
DOI: 10.1186/S12889-019-7631-2
Abstract: There is a well-established social gradient in smoking, but little is known about the underlying behavioral mechanisms. Here, we take a social-ecological perspective by examining daily stress experience as a process linking social disadvantage to smoking behavior. A s le of 194 daily smokers, who were not attempting to quit, recorded their smoking and information about situational and contextual factors for three weeks using an electronic diary. We tested whether socioeconomic disadvantage (indicated by educational attainment, income and race) exerts indirect effects on smoking (cigarettes per day) via daily stress. Stress experience was assessed at the end of each day using Ecological Momentary Assessment methods. Data were analyzed using random effects regression with a lower-level (2-1-1) mediation model. On the within-person level lower educated and African American smokers reported significantly more daily stress across the monitoring period, which in turn was associated with more smoking. This resulted in a small significant indirect effect of daily stress experience on social disadvantage and smoking when using education and race as indicator for social disadvantage. No such effects were found when for income as indicator for social disadvantage. These findings highlight the potential for future studies investigating behavioral mechanisms underlying smoking disparities. Such information would aid in the development and improvement of interventions to reduce social inequality in smoking rates and smoking rates in general.
Publisher: American Psychological Association (APA)
Date: 11-2014
DOI: 10.1037/HEA0000085
Abstract: The effects of self-efficacy beliefs on physical activity are well documented, but much less is known about the origins of self-efficacy beliefs. This article proposes scales to assess the sources of self-efficacy for physical activity aims and to comparatively test their predictive power for physical activity via self-efficacy over time to detect the principal sources of self-efficacy beliefs for physical activity. A study of 1,406 German adults aged 16-90 years was conducted to construct scales to assess the sources of self-efficacy for physical activity (Study 1). In Study 2, the scales' predictive validity for self-efficacy and physical activity was tested in a s le of 310 older German adults. Short, reliable and valid instruments to measure six sources of self-efficacy for physical activity were developed that enable researchers to comparatively test the predictive value of the sources of self-efficacy. The results suggest that mastery experience, self-persuasion, and reduction in negative affective states are the most important predictors of self-efficacy for physical activity in community-dwelling older adults.
Publisher: Oxford University Press (OUP)
Date: 29-03-2013
Abstract: This study tests whether enhancing alcohol risk messages with self-affirmation, the process of focusing on cherished aspects of oneself, increases intentions to reduce alcohol consumption and reduces actual alcohol consumption. It was also examined whether these effects differed by risk status as indicated by standard drinks consumed in an average week. Participants (n = 121) were randomly allocated to a self-affirmation or matched control condition before viewing emotive graphic alcohol warning posters in a questionnaire-based study. There were significant increases in intentions to reduce alcohol consumption in self-affirmed participants, and these effects were stronger in participants with higher behavioural risk. Intentions in turn significantly predicted a reduction in self-reported alcohol consumption. These findings support the use of self-affirmation to enhance alcohol awareness c aigns, particularly in in iduals with high behavioural risk.
Publisher: American Psychological Association (APA)
Date: 2013
DOI: 10.1037/A0029887
Abstract: Health promotion often faces the problem that populations with high behavioral risk profiles respond defensively to health promotion messages by negating risk or reactant behavior. Self-affirmation theory proposes that defensive reactions are an attempt of the self-system to maintain integrity. In this article, we examine whether a self-affirmation manipulation can mitigate defensive responses to personalized visual risk feedback in the skin cancer prevention context (ultraviolet [UV] photography), and whether the effects pertain to in iduals with high behavioral risk status (high personal relevance of tanning). We conducted a full-factorial randomized controlled trial (N = 292 age 11-71) following a 2 * 2 design (UV photo yes/no, self-affirmation yes/no). Follow-up period was 2 weeks. Subsequent tanning behavior, sun avoidance intentions, and risk perception. A multivariate analysis of variance (MANOVA) revealed a three-way interaction between risk feedback, the self-affirmation manipulation, and risk status for the three outcome measures. Follow-up analyses of variance (ANOVAs) indicated that high-risk in iduals receiving only the risk feedback intervention reacted defensively and reported higher exposure. A self-affirmation manipulation mitigates this reactance effect both on the level of cognitions and behavior. Self-affirmation has influential implications not only for Social Psychology but also for health prevention measures. The findings support the effectiveness of self-affirmation in reducing reactant and defensive reactions to personalized visual risk feedback. Interactions with health risk status indicate that self-affirmation might increase the effectiveness of health promotion messages in high-risk populations.
Publisher: Wiley
Date: 23-12-2010
Publisher: American Psychological Association (APA)
Date: 2011
DOI: 10.1037/A0021881
Abstract: Medication adherence often lies below recommendations although it is crucial for effective therapies, particularly in older adults with multiple illnesses. Medication beliefs are important factors for in idual adherence, but little is known about their origin. We examine whether changes in functional health predict changes in medication beliefs, and whether such changes in beliefs predict subsequent medication adherence. At three points in time over a 6-month period, 309 older adults (65-85 years) with multiple illnesses were assessed. Latent true change modeling was used to explore changes in functional health and medication beliefs. Adherence was regressed on changes in beliefs. Medication beliefs were measured by the Beliefs About Medicines Questionnaire medication adherence by the Reported Adherence to Medication Scale. Functional health and medication beliefs changed over time. Increasing physical limitations predicted increases in specific necessity and specific concern beliefs, but not in general beliefs. Changes in specific necessity beliefs predicted intentional adherence lapses, changes in general overuse beliefs predicted unintentional adherence lapses. Medication beliefs partly depend on health-related changes, and changes in beliefs affect in idual adherence, suggesting to target such beliefs in interventions and to support older adults in interpreting health changes.
Publisher: Informa UK Limited
Date: 16-04-2015
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: Center for Open Science
Date: 22-12-2021
Abstract: Misinformation on social media is a key challenge to effective and timely public health responses. Existing mitigation measures include flagging misinformation or providing links to correct information but have not yet targeted social processes. Here, we examine whether providing balanced social reference cues in addition to flagging misinformation leads to reductions in sharing behavior and improvement of overall sharing quality. In 3 field experiments (N=824, N=322, and N=278) on Twitter, we show that highlighting which content others within the personal network share and, more importantly, not share combined with misinformation flags significantly and meaningfully reduces the amount of misinformation shared and improves sharing quality (Study 1-3). We show that this improvement could be driven by change in injunctive social norms (Study 2) but not social identity (Study 3). Social reference cues, combined with misinformation flags, are feasible and scalable means to effectively curb sharing misinformation on social media.
Publisher: JMIR Publications Inc.
Date: 02-05-2017
DOI: 10.2196/MHEALTH.7168
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.SOCSCIMED.2013.03.012
Abstract: With increasing age and multimorbidity, medication regimens become demanding, potentially resulting in suboptimal adherence. Social support has been discussed as a predictor of adherence, but previous findings are inconsistent. The study examines general social support, medication-specific social support, and social conflict as predictors of adherence at two points in time (6 months apart) to test the mobilization and social conflict hypotheses. A total of 309 community-dwelling multimorbid adults (65-85 years, mean age 73.27, 41.7% women most frequent illnesses: hypertension, osteoarthritis and hyperlipidemia) were recruited from the population-representative German Ageing Survey. Only medication-specific support correlated with adherence. Controlling for baseline adherence, demographics, physical fitness, medication regimen, and attitude, Time 1 medication-specific support negatively predicted Time 2 adherence, and vice versa. The negative relation between earlier medication-specific support and later adherence was not due to mobilization (low adherence mobilizing support from others, which over time would support adherence). Social conflict moderated the medication-specific support to adherence relationship: the relationship became more negative, the more social conflict participants reported. Presence of social conflict should be considered when received social support is studied, because well-intended help might have the opposite effect, when it coincides with social conflict.
Publisher: Wiley
Date: 08-06-2008
Publisher: The Royal Society
Date: 16-05-2022
Abstract: We are dependent on our oceans for economic, health and social benefits however, demands on our oceans are escalating, and the state of the oceans is deteriorating. Only 2% of countries are on track to achieve the desired outcomes for the sustainable development goal (SDG 14) for the oceans by 2030, and the changes needed to prevent further degradation, or limit the impact of existing degradation, are not being undertaken fast enough. This paper uses a socio-ecological lens to explore the nature of actors and behaviours for change at the local, community, state, national and international levels, and introduces the need for technology, information- and knowledge-sharing, and policy as interconnected mediators, that work both in concert, and independently, to address the ‘super wicked’ problem of ocean health and to promote resilience. We recommend the need to develop transformational teams and leaders, as well as transformative policies within a holistic and integrated system to ensure ocean health initiatives are greater than the sum of their parts and are actual, realistic, achievable and evidence-informed pathways to change. This article is part of the theme issue ‘Nurturing resilient marine ecosystems’.
Publisher: JMIR Publications Inc.
Date: 22-07-2020
DOI: 10.2196/15948
Abstract: It has been observed that eating is influenced by the presence and availability of food. Being aware of the presence of food in the environment may enable mobile health (mHealth) apps to use geofencing techniques to determine the most appropriate time to proactively deliver interventions. To date, however, studies on eating typically rely on self-reports of environmental contexts, which may not be accurate or feasible for issuing mHealth interventions. This study aimed to compare the subjective and geographic information system (GIS) assessments of the momentary food environment to explore the feasibility of using GIS data to predict eating behavior and inform geofenced interventions. In total, 72 participants recorded their food intake in real-time for 14 days using an ecological momentary assessment approach. Participants logged their food intake and responded to approximately 5 randomly timed assessments each day. During each assessment, the participants reported the number and type of food outlets nearby. Their electronic diaries simultaneously recorded their GPS coordinates. The GPS data were later overlaid with a GIS map of food outlets to produce an objective count of the number of food outlets within 50 m of the participant. Correlations between self-reported and GIS counts of food outlets within 50 m were only of a small size (r=0.17 P .001). Logistic regression analyses revealed that the GIS count significantly predicted eating similar to the self-reported counts (area under the curve for the receiver operating characteristic curve [AUC-ROC] self-report=0.53, SE 0.00 versus AUC-ROC 50 m GIS=0.53, SE 0.00 P=.41). However, there was a significant difference between the GIS-derived and self-reported counts of food outlets and the self-reported type of food outlets (AUC-ROC self-reported outlet type=0.56, SE 0.01 P .001). The subjective food environment appears to predict eating better than objectively measured food environments via GIS. mHealth apps may need to consider the type of food outlets rather than the raw number of outlets in an in idual’s environment.
Publisher: Oxford University Press (OUP)
Date: 31-08-2006
DOI: 10.1093/HER/CYL084
Abstract: Health behavior interventions may have different effects when targeting in iduals at different stages of change. A 'motivation' stage, during which intentions are formed, has been distinguished from a 'volition' stage, implying that the latter requires self-regulatory effort in implementing and maintaining behavior. To test this stage assumption, an action control intervention (self-monitoring tool for dental flossing) matched to the volition stage and mismatched to the motivation stage was provided to 151 university students, with follow-up measures of action control and flossing after 2 and 6 weeks. Separate regression analyses for motivational and volitional participants indicated that only volitional participants benefited from the volitional intervention. This supports the usefulness of stage assumptions and the advantage of tailoring interventions to participants who reside either in the motivational or in the volitional stage.
Publisher: Informa UK Limited
Date: 15-05-2015
DOI: 10.1080/13607863.2015.1040724
Abstract: Face-to-face delivery of CBT is not always optimal or practical for informal dementia carers (DCs). Technology-based formats of CBT delivery (TB-CBT) have been developed with the aim to improve client engagement and accessibility, and lower delivery costs, and offers potential benefits for DCs. However, research of TB-CBT for DCs has maintained heavy reliance on therapist involvement. The efficacy of pure TB-CBT interventions for DCs is not currently established Methods: A systematic review of trials of pure TB-CBT intervention for DCs from 1995 was conducted. PsycINFO, Cochrane Reviews, Scopus and MedLine databases were searched using key terms related to CBT, carers and dementia. Four hundred and forty two articles were identified, and inclusion/exclusion criteria were applied studies were only retained if quantitative data was available, and there was no active therapist contact. Four articles were retained two randomized and two waitlist control trials. Methodological and reporting quality was assessed. Meta-analyses were conducted for the outcome measures of caregiver depression. Meta-analysis revealed small significant post-intervention effects of pure TB-CBT interventions for depression equivalent to face-to-face interventions. However, there is no evidence regarding long-term efficacy of pure TB-CBT for DCs. The systematic review further identified critical methodological and reporting shortcomings pertaining to these trials Conclusions: Pure TB-CBT interventions may offer a convenient, economical method for delivering psychological interventions to DCs. Future research needs to investigate their long-term efficacy, and consider potential moderating and mediating factors underpinning the mechanisms of effect of these programs. This will help to provide more targeted interventions to this underserviced population.
Publisher: Oxford University Press (OUP)
Date: 05-07-2016
DOI: 10.1093/NTR/NTW167
Abstract: Emotive health messages are widely used tools in tobacco control. However, under some circumstances, they can be less effective than desired by eliciting defensive responses in smokers. This study tests whether enhancing a currently used emotive graphic smoking health warning with a self-affirmation component reduces cigarette consumption and whether potential effects are stronger in heavier smokers, as suggested by previous research. Participants (n = 265) were randomly allocated to a self-affirmation (reflecting on personal values and positive traits using a questionnaire) or matched control condition before viewing an emotive graphic health message from a current Australian government public health c aign. The primary outcome (cigarettes per day [CPD]) was assessed both before and a week following the intervention. No main effect of self-affirmation on smoking, but as hypothesized, a significant interaction between baseline smoking and self-affirmation was found that showed that heavier smokers (>21 CPD) who self-affirmed significantly reduced CPD compared to nonaffirmed smokers. These findings support the use of self-affirmation to enhance smoking awareness c aigns in heavier smokers. This study shows that enhancing emotive graphic smoking health messages with self-affirmation (the act of reflecting on positive aspects of oneself) increases their effectiveness in heavier smokers. This suggests that self-affirmation might be a particularly useful tool for health promotion targeting heavier smokers. This study adds to previous research in that it is the first to test the add-on effects of self-affirmation to current graphic health messages on smoking rather than smoking-related cognitions.
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.APPET.2017.03.012
Abstract: Discretionary food choices (snacks) contribute up to a third of the daily energy intake and potentially contribute to energy imbalance and weight gain. In idual snack intake behaviour is guided by internal and external cues, with social cues (seeing others eat, being alone) consistently showing large effects. A wide body of (mainly laboratory-based) research suggests marked differences in people's response to eating cues based on BMI. Here, we show that these BMI differences in cue responsiveness also pertain to everyday snacking behaviour. In two combined ecological momentary assessment studies, 122 participants with BMIs ranging from 18.34 to 45.71 kg/m
Publisher: Center for Open Science
Date: 30-05-2019
Abstract: Objective: Health inequalities are partly due to inequalities in health behaviours. However, little is known about psychosocial mechanisms underlying health behaviour inequalities. Health behaviour determinants, e.g., those outlined in the Theoretical Domains Framework (TDF) may help understanding health behaviour inequalities. Previously two effect pathways have been theorized: behavioural determinants as mediators of the relationship between inequalities and health behaviour and inequalities as moderators of the relationship between behavioural determinants and health behaviour. This systematic review will summarise the existing literature on both pathways.Design: Relevant databases will be searched systematically for observational quantitative studies examining the indirect or moderating effects of inequality in the relationship between health behaviour determinants and health behaviour. Health behaviour determinants will be categorized according to the TDF, inequality indicators will be operationalized according to the PROGRESS-Plus framework. We will extract estimates of indirect effects and estimates of interaction effects. Quantitative meta-analysis will be conducted if study numbers allow.Discussion: This systematic review will summarise the current of evidence on indirect or moderating effects of social inequality in the relationship between determinants of health behaviour and health behaviour. The results of this review have substantial relevance for theory development, theory refinement and development of equity-focused interventions.Keywords: Social Inequality, Health Behaviour, Determinants of Health Behaviour, Theoretical Domains Framework, Mediation, Moderation
Publisher: Springer Singapore
Date: 2015
Publisher: Elsevier BV
Date: 05-2017
Publisher: MDPI AG
Date: 14-04-2022
Abstract: In iduals’ perceived fairness or justice beliefs are related to health in numerous ways. However, environment justice research to date has given little attention to perceived fairness of environmental exposures as experienced by in iduals. This study explored the feasibility of a bottom-up digital participatory (via mobile phones) approach using ecological momentary assessment (EMA) to capture in iduals’ subjective experience of environmental exposures and the subjective evaluation of fairness by those affected in the context of Nepal. In total, 22 in iduals participated in the study for 28 days. The results show high rates of study retention and adherence. In iduals’ justice perception was found to vary within and between in iduals, but also substantially depending on the types of environmental exposures. Nevertheless, the study indicates that uncertainties are inevitable as study design and timing may conflict participants’ daily lives and priorities. The method allows us to consider multiple geographic contexts of in iduals’ everyday lives beyond residential environment. This pilot study proved the possibility to assess perceptions of environmental justice issues and demonstrated the necessary steps to using digital participatory method for assessing subjective perception of fairness of in iduals.
Publisher: Elsevier BV
Date: 02-2011
DOI: 10.1016/J.JPSYCHORES.2010.07.014
Abstract: To examine factors preventing medication nonadherence in community-dwelling older adults with multiple illnesses (multimorbidity). Nonadherence threatens successful treatment of multimorbidity. Adherence problems can be intentional (e.g., deliberately choosing not to take medicines or to change medication dosage) or unintentional (e.g., forgetting to take medication) and might depend on a range of factors. This study focused in particular on the role of changes in beliefs about medication to explain changes in adherence. Longitudinal study with N = 309 in iduals aged 65-85 years with two or more diseases at three measurement points over six months. Medication adherence and beliefs about medicines were assessed by questionnaire. Hierarchical weighted least squares regression analyses were used to predict in idual intentional and unintentional nonadherence. Changes in intentional nonadherence were predicted by changes in specific necessity beliefs (B = -.19, P<.01), after controlling for sociodemographic factors, health status and number of prescribed medicines. Changes in unintentional nonadherence were predicted by changes in general overuse beliefs (B = .26, P<.01), controlling for the same covariates. Beliefs about medication affect both intentional and unintentional adherence to medication in multimorbid older adults. This points to the importance of addressing medication beliefs in patient education to improve adherence.
Publisher: Hogrefe Publishing Group
Date: 07-2008
DOI: 10.1026/0943-8149.16.3.161
Abstract: Abstract. With increasing life expectancy in industrialised countries, more and more in iduals can expect to reach high age. However, aging is often associated with increasing morbidity and decreasing quality of life (QoL). A central question therefore is, which resources determine whether these additional years are healthy years with high QoL. Data from a representative, population-wide survey (German Ageing Survey) suggest that age-related decreases in QoL are mediated by multimorbidity. Older in iduals with little morbidity enjoy good QoL. To further explore these complex relations, we present a research agenda for resources fostering health and QoL despite multimorbidity. This article is an overview of research at the German Centre of Gerontology in the domain of aging and health. The German Centre of Gerontology is a multidisciplinary research institute which examines age-related phenomena from psychological and sociological perspectives. Research questions related to Health Psychology are examined in the context of representative surveys and theory-based studies.
Publisher: Oxford University Press (OUP)
Date: 30-08-2023
DOI: 10.1093/ABM/KAAD050
Abstract: To control infections, behavioral non-pharmaceutical interventions (NPIs) such as social distancing and hygiene measures (masking, hand hygiene) were implemented widely during the COVID-19 pandemic. At the same time, adherence to NPIs has also been implied in an increase in mental health problems. However, the designs of many existing studies are often poorly suited to disentangle complex relationships between NPI adherence, mental health symptoms, and health-related cognitions (risk perceptions, control beliefs). To separate between- and temporal within-person associations between mental health, health-related cognitions, and NPI adherence. Six-month ecological momentary assessment (EMA) study with six 4-day assessment bouts in 397 German adults. Daily measurement of adherence, mental health symptoms, and cognitions during bouts. We used dynamic temporal network analysis to estimate between-person, as well as contemporaneous and lagged within-person effects for distancing and hygiene NPIs. Distinct network clusters of mental health, health cognitions, and adherence emerged. Participants with higher control beliefs and higher susceptibility were also more adherent (between-person perspective). Within-person, similar findings emerged, additionally, distancing and loneliness were associated. Lagged findings suggest that better adherence to NPIs was associated with better mental health on subsequent days, whereas higher loneliness was associated with better subsequent hygiene adherence. Findings suggest no negative impact of NPI adherence on mental health or vice versa, but instead suggest that adherence might improve mental health symptoms. Control beliefs and risk perceptions are important covariates of adherence—both on between-person and within-person level.
Publisher: Ubiquity Press, Ltd.
Date: 2018
DOI: 10.5334/JOPD.35
Publisher: Wiley
Date: 05-07-2016
DOI: 10.1002/JCLP.22328
Abstract: Seligman, Steen, Park, and Peterson (2005) suggested that positive psychology interventions (PPIs) contain specific, powerful, therapeutic ingredients that effect greater increases in happiness and reductions in depression than a placebo control. This study reexamined the three PPIs that Seligman et al. found to be most effective when delivered over the internet. Three PPIs and a placebo control, identical with the interventions used by Seligman et al., were examined in a web-based, randomized assignment design. Mixed-design analysis of variance and multilevel modeling showed that all interventions, including the placebo, led to significant increases in happiness and reductions in depression. The effects of PPIs were indistinguishable from those of the placebo control. Using web-based delivery, both PPIs and theoretically neutral placebos can increase happiness and reduce depression in self-selected populations. Possible explanations include that non-specific factors common to most therapeutic treatments are responsible for the observed changes, or that cultural or other context-related variables operate to account for the ergent findings.
Publisher: Wiley
Date: 09-12-2020
DOI: 10.1111/BJHP.12402
Abstract: Objectives Health behaviour theories outline how cognitions predict behaviours, but rarely specify the temporal relation between cognitions and behaviours. It is not known whether these predictive relationships vary depending on temporal resolution or whether the relative influence of cognitions varies with measurement schedules. The current exploratory study therefore investigates whether the associations between behavioural cognitions (self-efficacy, intention, and risk perception) and smoking vary when measured momentarily, at day level, or using the more common baseline-follow-up design. Design EMA study involving 36 continuing smokers over 17 days. Participants logged cigarettes and reported their cognitions at baseline, daily (evening), and in response to momentary surveys. Methods Random-effects models were used to compare the effects of cognitions measured at different time points on (1) the number of cigarettes smoked daily and (2) the time interval until the next cigarette smoked. Results Self-efficacy and risk perception measured at baseline significantly predicted cigarettes smoked each day, but this effect became non-significant when daily measurements of cognitions were included in the model. Momentary smoking behaviour was predicted by momentary measurements of risk perception, with no significant effects of social cognitions at baseline. Conclusions Relationships between cognitions and behaviours vary according to the temporal resolution of the measurement schedule. Ensuring that the temporal resolution of assessment is appropriate for the temporal dynamics of the behaviour being assessed is important. Future research is needed to investigate the potential for leveraging specific cognitive processes depending on temporal importance in order to increase health-promoting behaviours. Statement of contribution What is already known on this subject? Social cognitions including intentions, risk perception, and self-efficacy have been observed to predict smoking. Little is known about the role of time in the cognition-behaviour relationship. Cognitions have been observed to fluctuate, but instability is typically not considered in research design. What does this study add? Daily measurement of social cognitions predicts behaviour better than measurements taken at baseline. Momentary smoking behaviour is predicted by momentary cognitions at the intra-in idual level. Temporal resolution of measurement should be considered when investigating cognition-behaviour relationships.
Publisher: Wiley
Date: 03-04-2016
DOI: 10.1111/APHW.12066
Abstract: Diseases such as skin cancer often have a very long latency period. For adolescents, especially, it may be difficult to grasp that current risk behavior is related to future health outcomes. This study examines the role of health-related time perspective (i.e. the degree to which short-term outcomes are discounted over long-time health benefits) within the Health Action Process Approach (HAPA). More specifically, based on expectancy*value theory, we tested whether time perspective interacts with self-efficacy, the central variable in this approach. A longitudinal study with three measurement points across one year assessed 156 high school students. Data were analyzed using structural equation models. While time perspective had no direct association with sunscreen use intentions, there was an interaction effect with self-efficacy the shorter the time perspective, the smaller the association of self-efficacy with intention. Intention in turn predicted planning and sunscreen use at Time 3 (one year later). In order to maximise the impact of early onset measures for skin cancer prevention targeting the motivation for sunscreen use in adolescents, time perspective should be addressed in comprehensive sun protection interventions.
Publisher: Wiley
Date: 20-07-2006
Publisher: Wiley
Date: 11-06-2015
DOI: 10.1111/APHW.12046
Abstract: Dementia prevalence and the demand for dementia care are increasing. Informal caregiving accounts for a large proportion of dementia care, but can come at high cost for caregivers. Informal dementia caregivers are at higher risk for mental health problems than the general population. This study examines whether perceived change in leisure activities is one working mechanism linking stress and burden experience in dementia caregiving to lower mental health (depressive symptoms, anxiety symptoms, and reduced satisfaction with life), and whether there are group-based leisure activities that can buffer this detrimental effect. A total of 346 informal Australian dementia caregivers (88.15% female, age 18-82 years) participated in an online study. Mediation and moderation analyses using multiple regression demonstrated that perceived changes in leisure activities linked caregiving stress and burden to lower mental health, and that membership in groups engaging in affiliation or social activities attenuates negative effects of caregiving. Informal dementia caregivers benefit from satisfying leisure activities. In particular, engaging in social activities and self-help groups buffered the negative impact of caregiving.
Publisher: Wiley
Date: 24-05-2011
Publisher: Wiley
Date: 18-11-2022
DOI: 10.1111/APHW.12322
Abstract: Trajectories of chronic illnesses depend on patient socioeconomic status (SES). This study examines main and equity effects (age, gender, education, region of residence) of a brief telephone self‐management intervention on self‐rated health and depressive symptoms of health insurance clients with chronic illnesses. Randomized invitation design ( n = 2628) with predominantly male (82%) older in iduals (modal age = 65–74) with one or more chronic illnesses. Primary outcomes: Self‐rated health and depressive symptoms. Intervention: Brief CBT‐based telephone counseling. Propensity score matching was used to equate intervention and control groups ( n = 1314 pairs). Change score models were used to analyze changes in health‐related outcome measures. The intervention resulted in improvements in self‐rated health ( d = .37) and fewer depressive symptoms ( d = .17) over 4 and 6 months. There were comparable effects across education and regions, but younger and female participants profited more from the intervention compared with older and male participants. A brief telephone‐based intervention led to improved self‐rated health and well‐being in a large s le of participants with chronic health conditions. This effect was observed over and above regular medical care. The intervention was equitable with respect to education and region, but not age and gender.
Publisher: SAGE Publications
Date: 07-2010
Abstract: Multimorbidity challenges quality of life (QoL) in old age. Anticipating and providing social support have been shown to promote QoL whereas receiving support often had detrimental effects. Little is known about which psychological processes explain these effects. This study examines the effects of receiving, anticipating and providing emotional support on QoL, with control beliefs and self-esteem as simultaneous mediators in an elderly multimorbid s le ( N = 1415). Anticipating and providing support positively predicted QoL, mediated through self-esteem and control beliefs. Received support negatively predicted QoL, without mediation. Self-esteem and control beliefs can help to explain the relation between QoL and support.
Publisher: Informa UK Limited
Date: 12-12-2013
DOI: 10.1080/08870446.2013.863884
Abstract: Previous research on illness perceptions has focused on single illnesses, but most adults over 65 suffer from multiple illnesses (multimorbidity). This study tests three competing operationalisations of multiple illness perceptions in predicting physical functioning and adherence: (1) main effects and interactions model (2) peak model with effects of the most prominent illness perception and (3) combined model with averaged illness perceptions over multiple illnesses. Longitudinal study in N = 215 in iduals (65-86 years) with multimorbidity at two measurement points over six months. Participants filled in two Brief Illness Perception Questionnaires (B-IPQ) on their two most severe illnesses. Physical functioning, medication adherence. Factor analyses suggest that the B-IPQ contains three dimensions consequences, control and timeline. Multiple regression models fit the data best for (1) and (3). Timeline (β = -.18) and control (β = .21) predict adherence in (1) consequences (β = .16) and control (β = .20) in (3). Physical functioning was significantly predicted by interacting control beliefs in (1 β = .13), by peak consequences in (2 β = -.14) and by consequences (β = -.15) in (3). In iduals with multimorbidity hold both distinct and combined perceptions about their illnesses. To understand in idual responses to multimorbidity, perceptions about all illnesses and multimorbidity as entity should be examined.
Publisher: American Psychological Association (APA)
Date: 2013
DOI: 10.1037/A0032845
Abstract: Recent studies have provided considerable evidence on long-term effects of self-perceptions of aging (SPA) on indicators of successful aging such as health or life satisfaction. To date, little is known about the mechanisms underlying these effects. This study therefore examined whether negative SPA impair the use of self-regulation strategies that include selection, optimization, and compensation (SOC) in case of a serious health event and thus turn into self-fulfilling prophecies for health and life satisfaction. Based on a longitudinal nationwide study with 2 measurement points over a 6-month period in 309 older people (65+ years of age) with multiple illnesses, 2 major findings emerged: First, the occurrence of a serious health event predicted increased use of SOC strategies, which in turn predicted higher self-rated health and life satisfaction. Second, this effect was moderated by negative SPA, that is, in case of a serious health event, the perception that aging is associated with physical losses led to lower use of SOC strategies promoting a healthy lifestyle (B = -0.43, SE = 0.15, p < .01). These findings contribute to a better understanding of the underlying mechanisms of SPA on health by showing that negative SPA as associated with physical losses might impair health-related strategies that are important for maintaining a healthy lifestyle. Future intervention studies could attempt to challenge negative SPA to support effective strategy use in older adults with serious illnesses.
Publisher: JMIR Publications Inc.
Date: 08-01-2023
Abstract: ealth-related misinformation on social media is a key challenge to effective and timely public health responses. Existing mitigation measures include flagging misinformation or providing links to correct information, but they have not yet targeted social processes. Current approaches focus on increasing scrutiny, providing corrections to misinformation (debunking), or alerting users prospectively about future misinformation (prebunking and inoculation). Here, we provide a test of a complementary strategy that focuses on the social processes inherent in social media use, in particular, social reinforcement, social identity, and injunctive norms. his study aimed to examine whether providing balanced social reference cues (ie, cues that provide information on users sharing and, more importantly, i not /i sharing specific content) in addition to flagging COVID-19–related misinformation leads to reductions in sharing behavior and improvement in overall sharing quality. total of 3 field experiments were conducted on Twitter’s native social media feed (via a newly developed browser extension). Participants’ feed was augmented to include misleading and control information, resulting in 4 groups: no-information control, Twitter’s own misinformation warning (misinformation flag), social cue only, and combined misinformation flag and social cue. We tracked the content shared or liked by participants. Participants were provided with social information by referencing either their i ersonal /i network on Twitter or all Twitter users. total of 1424 Twitter users participated in 3 studies (n=824, n=322, and n=278). Across all 3 studies, we found that social cues that reference users’ personal network combined with a misinformation flag reduced the sharing of misleading but not control information and improved overall sharing quality. We show that this improvement could be driven by a change in injunctive social norms (study 2) but not social identity (study 3). ocial reference cues combined with misinformation flags can significantly and meaningfully reduce the amount of COVID-19–related misinformation shared and improve overall sharing quality. They are a feasible and scalable way to effectively curb the sharing of COVID-19–related misinformation on social media.
Publisher: American Psychological Association (APA)
Date: 2014
DOI: 10.1037/A0036248
Abstract: Self-perceptions of aging, important indicators of successful aging, are closely linked to health. Previous research has mainly examined the role of in idual factors on self-perceptions of aging, but health is partly dependent on contextual factors such as primary care supply. This study therefore examined whether the impact of diseases on self-perceptions of aging is buffered by primary care supply in the district, as it ensures sustained health care continuity. Nationally representative German survey data on health and self-perceptions of aging (N = 4,442, 40-85 years) were linked to primary care supply (general practitioner density in regional districts). Multilevel modeling shows that the impact of disease burden (multiple illnesses) was buffered by primary care supply: Disease burden was less strongly associated with negative self-perceptions of aging in districts with good primary health care supply. This underlines the importance of health care resources for successful aging.
Publisher: American Psychological Association (APA)
Date: 03-2016
DOI: 10.1037/ADB0000146
Abstract: The purpose of this study is to examine the immediate, everyday impact of health warnings on cigarette packages on potential smoking cessation mediators and to test for differences in immediate reactions to branded and plain tobacco packaging during the transition phase when plain packs where first introduced in Australia. Two Ecological Momentary Assessment studies tested whether smokers report higher risk appraisals, self-efficacy, and quitting intentions immediately after seeing a warning compared to random times of the day (Study 1), and whether smoking from plain packs results in higher quitting intention, risk appraisal, and self-efficacy than smoking from branded packs (Study 2). There was no immediate increase in self-efficacy, risk appraisal, or intention after encountering health warnings, and no differences in cognitions when using plain compared with branded packs. Moreover, cognitions were not different when warnings were encountered in proximity to smoking compared to nonsmoking events. However, self-efficacy and risk appraisal were significantly associated with quitting intention. Current health warnings do not seem to have an immediate impact on important predictors of quitting intention and might benefit from including messages that place a stronger focus on increasing smokers' confidence that they can quit. Replication of the results with larger s le and cluster sizes is warranted.
Publisher: SAGE Publications
Date: 09-07-2016
Abstract: Health-risk information can elicit negative emotions like anticipated regret that may positively affect health persuasion. The beneficial impact of such emotions is undermined when target audiences respond defensively to the threatening information. We tested whether self-affirming (reflecting on cherished attributes) before message exposure can be used as strategy to enhance the experience of anticipated regret. Women were self-affirmed or not before exposure to a message promoting fruit and vegetable consumption. Self-affirmation increased anticipated regret and intentions reported following message exposure and consumption in the week after the intervention regret mediated the affirmation effect on intentions. Moreover, results suggest that anticipated regret and intentions are serial mediators linking self-affirmation and behavior. By demonstrating the mediating role of anticipated regret, we provide insights into how self-affirmation may promote healthy intentions and behavior following health message exposure. Self-affirmation techniques could thus potentially be used to increase the effectiveness of health communication efforts.
Publisher: Springer Science and Business Media LLC
Date: 05-09-2023
Publisher: Hindawi Limited
Date: 06-2012
DOI: 10.1017/JSC.2012.11
Abstract: The majority of smokers indicate that they would like to quit. It has been estimated that approximately three quarters of Australian smokers have tried to change their behaviour in the last 12 months (Scollo & Winstanley, 2008) similarly, more than half of US smokers report having tried to quit in the last year (Centers for Disease Control and Prevention [CDC], 2011). Despite their interest in quitting, the proportion of smokers who successfully quit each year is very low (CDC, 2011). While other factors are also important, poor cessation rates can partly be attributed to the low uptake of efficacious smoking cessation methods, particularly pharmacotherapies (Shiffman, Brockwell, Pillitteri, & Gitchell, 2008).
Publisher: Oxford University Press (OUP)
Date: 06-10-2015
Abstract: Large longitudinal studies show that negative self-perceptions of aging can be detrimental for health outcomes. However, negative self-perceptions of aging (i.e., associating aging with physical losses) might be adaptive because they prepare in iduals for serious health events (SHEs), resulting in short-term positive effects as opposed to long-term negative effects on well-being and health. Longitudinal data from 309 older adults (aged 65 and older) were analyzed. Short-term (6 months) and long-term (2.5 years) effects after a SHE of negative self-perceptions of aging on functional limitations (FLs) and negative affect (NA) were investigated. Results show that in the case of a SHE, in iduals with more negative self-perceptions of aging reported less NA after 6 months but more FLs after 2.5 years. In contrast, in iduals with less negative self-perceptions of aging reported more NA in the short-run but less FLs later on. People with more negative self-perceptions of aging may be mentally prepared for health events or may have habituated to health declines. In iduals with more positive self-perceptions, in contrast, may invest a lot in coping efforts immediately after the health event. Similarities to research on unrealistic optimism are discussed.
Publisher: Oxford University Press (OUP)
Date: 15-12-2006
Abstract: To investigate the utility of an extended Theory of Planned Behaviour (TPB), including descriptive norms and anticipated regret, in predicting binge-drinking intentions and behaviour. A total of 178 undergraduates completed a questionnaire containing measures of TPB variables, descriptive norms, anticipated regret, and previous binge-drinking behaviour. One week later, 104 students completed a measure of binge-drinking behaviour. Hierarchical regression demonstrated that attitudes (beta = 0.30, P < 0.001) and anticipated regret (beta = 0.47, P < 0.001) were significant predictors of intentions, with the final equation accounting for 58% of the variance. Hierarchial regression found that intentions (beta = -0.21, P < 0.05) and previous binge-drinking behaviour (beta = 0.36, P < 0.01) predicted current drinking behaviour, accounting for 33% of the variance. The study suggests that modifying attitudes and inducing regret may be effective strategies for reducing binge-drinking intentions among undergraduates, which should reduce subsequent binge-drinking behaviour.
Publisher: Springer Science and Business Media LLC
Date: 12-2011
DOI: 10.1007/S00391-011-0248-4
Abstract: The proportion of the population with multiple illnesses increases with age and growing numbers of people are now living to a very old age. Despite medical progress and improved living conditions, many old people have to deal with physical, psychological, and social impairments. It is a crucial challenge for health and social policy to support the elderly with health-related impairments in their desire to lead as independent a life as possible. Against this background the research consortium Autonomy Despite Multimorbidity in Old Age (AMA I) examined the extent to which the self-determined life style of multimorbid old and very old persons can be supported and maintained. In order to reflect the ersity of life worlds of the elderly, the study s le included participants who were not notably impaired in their everyday functioning, participants in need of nursing care and participants with cognitive impairments. Moreover, the s le comprised both older persons who were still living in their own homes and nursing home residents. The studies conducted within the AMA framework focused on the resources available to old persons living in different situations and on how these resources can be strengthened. This article presents findings from the first phase of funding of the AMA research consortium. In a second phase of funding (2011-2013, AMA II), sustainable practice-based interventions are being developed to mobilize resources which can help multimorbid older persons to maintain their autonomy and the practical viability of these interventions will be tested.
Publisher: Wiley
Date: 17-10-2007
Publisher: Hogrefe Publishing Group
Date: 07-2008
Publisher: Informa UK Limited
Date: 2009
DOI: 10.1080/08870440801958214
Abstract: Action planning is assumed to mediate between intentions and health behaviours. Moreover, intentions are assumed to moderate the planning-behaviour relation, because people with high intentions are more likely to enact their plans. The present studies extend these suppositions by integrating both assumptions to a novel and parsimonious model of moderated mediation: the mediation effect is hypothesised to be stronger in in iduals who report higher intention levels. In two longitudinal studies on physical activity (N = 124) and interdental hygiene (N = 209), intentions and action planning were assessed at baseline, and behaviour was measured four (Study 1), and respectively, three (Study 2) months later. The moderated mediation hypothesis was tested with continuously measured intentions using regression analyses with non-parametric bootstrapping. Results from both studies suggest that levels of intentions moderate the mediation process: The strength of the mediated effect increased along with levels of intentions. Planning mediates the intention-behaviour relation, if in iduals hold sufficient levels of intentions. Implications for theory advancement and intervention development are discussed.
Publisher: Wiley
Date: 18-05-2009
Publisher: American Psychological Association (APA)
Date: 02-2018
DOI: 10.1037/HEA0000568
Abstract: Social factors are among the most powerful and pervasive influences on eating behavior, snacking in particular. Previous research has shown that being in the presence of people who are eating significantly increases the likelihood of eating and affects the types as well as the amount of food consumed. Much less is known about the processes underlying social influence, but previous research has suggested social norms as mediators. In this study, we extended this perspective to everyday settings and examined whether the presence of other people eating leads to a change in perceived momentary norms, and whether this change predicts snack consumption in real life. We applied ecological momentary assessment to study 61 in iduals in the normal-obese weight range (M BMI = 24.97 kg/m² SD = 4.07) over a 14-day monitoring period. We used a combination of event-based snacking reports and randomly timed assessments. The presence of others eating and momentary perceptions of injunctive norms (facets of perceived appropriateness and encouragement) were measured for both assessment types. Mediated, multilevel logistic regression showed that social cues predict snacking (OR = 3.06), and that momentary perceptions of appropriateness (a*b = 0.14) and encouragement (a*b = 0.18) partially mediated these effects. Perceptions of momentary norms mediated the effects of social influence on everyday snacking, which highlights the importance of the social environment for understanding eating behavior. (PsycINFO Database Record
Publisher: Wiley
Date: 29-01-2009
Publisher: Oxford University Press (OUP)
Date: 16-05-2013
Abstract: It has been considered a fact that informal social activities promote well-being in old age, irrespective of whether they are performed with friends or family members. Fundamental differences in the relationship quality between family members (obligatory) and friends (voluntary), however, suggest differential effects on well-being. Further, age-related changes in networks suggest age-differential effects of social activities on well-being, as older adults cease emotionally detrimental relationships. Longitudinal representative national survey study with middle-aged (n = 2,830) and older adults (n = 2,032). Age-differential effects of activities with family members and friends on changes in life satisfaction, positive affect (PA), and negative affect (NA) were examined in latent change score models. In the middle-aged group, activities with friends and families increased PA and life satisfaction and were unrelated to NA. In the older age group, family activities increased both PA and NA and were unrelated to changes in life satisfaction, but activities with friends increased PA and life satisfaction and decreased NA. Social activities differentially affect different facets of well-being. These associations change with age. In older adults, the effects of social activities with friends may become more important and may act as a buffer against negative effects of aging.
Publisher: American Psychological Association (APA)
Date: 03-2013
DOI: 10.1037/A0028915
Abstract: Stage theories of health behavior are popular and of high practical relevance. Tests of the validity of these theories provide limited evidence because of validity and reliability problems. This study provides a bottom-up approach to identify behavioral stages from examining differences in underlying mindsets. We examine the concurrent validity of a latent-class-based approach and a commonly used stage-algorithm based on self-reports about intentions and behavior in order to identify possible strengths and shortcomings of previously used approaches. Social-cognitive variables and in iduals' stages were assessed in a s le of 2,219 internet users. Latent class analysis (LCA) was used to identify distinct groups with similar patterns of social-cognitive predictors. Convergent validity of the LCA solution and stage algorithms was tested by examining adjusted standardized residuals. The LCA identified four distinct profiles-not intending to change, intending to change (no action), intending to change with action, and maintaining. Convergent validity with a stage algorithm was low, in particular in the nonintending and maintaining stages. Stages as assigned by the stage-algorithm did not correspond well with the extracted mindsets: This indicates that commonly used stage-algorithms might not be effective in assigning in iduals to stages that represent mindsets, undermining the possibility for stage-matched interventions.
Publisher: American Psychological Association (APA)
Date: 2012
DOI: 10.1037/A0027596
Abstract: Although health behavior theories assume a role of the context in health behavior self-regulation, this role is often weakly specified and rarely examined. The two studies in this article test whether properties of the environment (districts) affect if and how health-related cognitions are translated into physical activity. Multilevel modeling was used to examine the assumed cross-level interactions. Study 1 is a large-scale survey representative of the German adult population (N = 6,201). Gross domestic product (GDP) on the level of administrative districts was used to indicate environmental opportunities and barriers. Study 2 examined cross-level interactions of proximal predictors of physical activity (intentions, action planning, and coping planning) in older adults with multiple illnesses (N = 309), a high-risk group for health deteriorations. Study 1 showed that on the in idual level, health attitudes (B = .11) and education (B = .71) were significantly associated with physical activity. GDP moderated the attitudes-behavior relation (B = .01), with higher attitude-behavior relations in districts with higher GDP. Study 2 finds that intention (B = .16), action planning (B = .17), and coping planning (B = .13) significantly predict activity. In addition, district-level GDP significantly moderated the relations between action planning and coping planning, but not intention, on physical activity. Results suggest that the effects of health attitudes and planning on physical activity are moderated by environmental factors. Districts with higher GDP provide better contextual opportunities for the enactment of concrete if-then plans for physical activity. This has implications for both theory and health promotion.
Publisher: Oxford University Press (OUP)
Date: 04-10-2023
DOI: 10.1093/NTR/NTAC229
Abstract: Smokers can respond defensively to health risk communication such as on-pack warning labels, potentially reducing their effectiveness. Theory suggests that risk perception together with self-efficacy reduces defensive responses and predicts target behaviors. Currently, tobacco warning labels globally predominantly target risk and do not explicitly consider efficacy. This study explores the effectiveness of combining Australian tobacco warning labels with efficacy content to increase quitting intentions. RCT in 83 smokers over 3 weeks. After a seven-day baseline phase (smoking from usual tobacco packaging), participants were randomized to one of two adhesive labels groups for the remaining 14 days: Standard health warning labels (HWLs) featuring enhanced efficacy messages (experimental group) or unmodified standard HWLs (control group). Participants attached these labels to their tobacco packaging and recorded their cognitions and smoking behavior once daily using Smartphones. Multilevel structural equation modeling was used to test theorized effects of the labels on self-efficacy, risk perception, and intentions to quit. There was no effect of exposure to efficacy messages on either self-efficacy, risk perceptions, or intentions to quit. However, self-efficacy and risk perceptions were positively associated with quitting intentions at the within-person level. The predictive relationships between self-efficacy, risk perception, and intention to quit were supported, however, supplementing standard warning labels with efficacy messages had no effect on these cognitions. Whether this is due to conditioned avoidance of HWLS, characteristics of the messages, or limitations imposed by format are unclear. Self-efficacy and risk perception predict intentions to quit smoking. Adding efficacy content to tobacco health warnings may have the potential to bolster these cognitions but more research is required to determine the contexts in which this would be effective and who would be likely to benefit. The time course by which exposure to efficacy content might influence cessation self-efficacy and downstream quitting intentions also needs to be investigated.
Publisher: Oxford University Press (OUP)
Date: 17-01-2008
DOI: 10.1093/HER/CYM092
Abstract: Stage theories of health behavior change assume that in iduals pass through qualitatively different stages on their way to the adoption of health behaviors. Three common stages (preintention, intention and action) can be defined by stage transitions included in current stage theories and supported by evidence. The present study examines whether transitions between these stages can be predicted by social cognition variables derived from prevailing health behavior theories. At two points in time, the motivation for interdental hygiene behaviors and oral self-care was assessed in 288 participants recruited in dental practices. Stage progression and regression over time were analyzed using discriminant function analysis. Progression from preintention to intention was predicted by action planning, whereas coping planning and self-efficacy predicted transitions from intention. Regression from action was predicted by self-efficacy. Results support the distinction of three common stages. Findings are discussed in terms of their contribution to health behavior theory.
Publisher: Oxford University Press (OUP)
Date: 28-11-2008
DOI: 10.1093/HER/CYN061
Abstract: Stage theories propose that in iduals pass through different stages on their way toward behavior change. The present study examines stage-specific prediction patterns of social-cognitive variables (risk perception, outcome expectancies, perceived self-efficacy, action planning and social support) regarding transitions between the three stages of the Health Action Process Approach (HAPA preintention, intention and action stage). In an online study (n = 494) on fruit and vegetable intake, social-cognitive variables and stages were assessed at baseline and stage transitions 4 weeks later. Transitions between the preintention, intention and action stage were predicted by social-cognitive variables using binary and multinomial logistic regression analyses. Stage-specific prediction patterns emerged for stage progression and stage regression. Outcome expectancies predicted progression from the preintention stage, whereas social support predicted progression to the action stage. Low levels of planning were associated with relapse to the preintention and the intention stage. Self-efficacy emerged as a universal predictor of stage transitions. Findings support not only the usefulness of the stage construct for describing health behavior change but also the validity of the HAPA variables as predictors of stage transitions. Stage-matched interventions targeting the variables identified as stage-specific predictors might support stage progression toward the goal behavior.
Publisher: Informa UK Limited
Date: 27-02-2015
DOI: 10.1080/08870446.2015.1014370
Abstract: Positive self-perceptions of ageing are associated with better health however, little is known about the potentially underlying mechanisms. The present longitudinal study examines whether the relationship between self-perceptions of ageing and self-rated health is mediated by physical activity in older adults with multiple chronic conditions. A s le of 309 German community-dwelling older adults aged 65-85 years with two or more chronic conditions was assessed at three measurement occasions over 2.5 years. Participants provided information on self-perceptions of ageing, physical activity, self-rated health, number of chronic conditions and demographics (T1). Physical activity was reassessed six months later (T2) and self-rated health after 2.5 years (T3). Data were analysed using multiple regression and path analyses. Self-rated health and physical activity. More positive self-perceptions of ageing were related to better self-rated health over a 2.5-year period controlling for confounding variables. Physical activity six months after T1 partially mediated this relationship. Having more positive self-perceptions of ageing is associated with higher levels of physical activity, which in turn predict better self-rated health over time. This supports the hypothesis of a behavioural pathway in the self-perceptions of ageing--health link.
Publisher: SAGE Publications
Date: 2022
DOI: 10.1177/20552076221129093
Abstract: The widely used socioecological rainbow model from Dahlgren and Whitehead specifies determinants of health inequity on multiple hierarchical levels and suggests that these determinants may interact both within and between levels. At the time of its inception, digital determinants only played a minor role in tackling inequities in public health and were therefore not specifically considered. This has dramatically changed: From today's perspective, health inequities increasingly depend on digital determinants. In this article, we suggest adapting the Dahlgren-Whitehead model to reflect these developments. We propose a model that allows formulating testable hypotheses, interpreting research findings, and developing policy implications against the background of the global spread of digital technologies. This may facilitate the development of a new line of research and logic models for public health interventions in the digital age. Using the COVID-19 pandemic as a case study, we illustrate how the digitization of all aspects of life affects the different levels of determinants of health inequities in the Dahlgren–Whitehead model. In doing so, we deliberately argue for not introducing a separate digital sphere in its own right, but for understanding digitization as a phenomenon that permeates all levels of determinants of health inequities. As a result, we present a digital rainbow model that integrates Dahlgren and Whitehead's 1991 model with digital environments to identify current health promotion and research issues without changing the rainbow model's initial structure.
Publisher: Springer Science and Business Media LLC
Date: 10-02-2011
Publisher: American Psychological Association (APA)
Date: 04-2017
DOI: 10.1037/HEA0000439
Abstract: In idual eating behavior is a risk factor for obesity and highly dependent on internal and external cues. Many studies also suggest that the food environment (i.e., food outlets) influences eating behavior. This study therefore examines the momentary food environment (at the time of eating) and the role of cues simultaneously in predicting everyday eating behavior in adults with overweight and obesity. Intensive longitudinal study using ecological momentary assessment (EMA) over 14 days in 51 adults with overweight and obesity (average body mass index = 30.77 SD = 4.85) with a total of 745 participant days of data. Multiple daily assessments of eating (meals, high- or low-energy snacks) and randomly timed assessments. Cues and the momentary food environment were assessed during both assessment types. Random effects multinomial logistic regression shows that both internal (affect) and external (food availability, social situation, observing others eat) cues were associated with increased likelihood of eating. The momentary food environment predicted meals and snacking on top of cues, with a higher likelihood of high-energy snacks when fast food restaurants were close by (odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.22, 2.93) and a higher likelihood of low-energy snacks in proximity to supermarkets (OR = 2.29, 95% CI = 1.38, 3.82). Real-time eating behavior, both in terms of main meals and snacks, is associated with internal and external cues in adults with overweight and obesity. In addition, perceptions of the momentary food environment influence eating choices, emphasizing the importance of an integrated perspective on eating behavior and obesity prevention. (PsycINFO Database Record
Publisher: American Psychological Association (APA)
Date: 2011
DOI: 10.1037/A0023839
Abstract: Subjective well-being (SWB) is an important predictor of mortality. To date, surprisingly little is known about whether cognitive and emotional facets of SWB independently predict mortality, and whether such effects vary by age. This study examined differential effects of life satisfaction (LS), positive affect (PA), and negative affect (NA) on mortality in a conjoint analysis using data of German adults between the ages of 40 to 85 years (N = 3,124). Effects of SWB facets were analyzed using Cox Proportional Hazards Models. LS and PA predicted mortality over and above sociodemographic factors and physical health (HRLS = .89, 95% CI = .79-1.00, p < .05, HRPA = .81, 95% CI = .70-.93, p < .05). However, this effect diminished when including self-rated health and physical activity. NA was not associated with mortality. Age group comparative analyses revealed that PA predicted mortality in older adults (65+) even after controlling for self-rated health and physical activity (HRPA = .82, 95% CI = .70-.97, p < .05). In middle-aged participants, no SWB indicator predicted mortality when controlling for covariates. These findings suggest a differential impact of cognitive and emotional well-being on mortality and suggest that in middle-aged adults the effects of SWB on mortality are attenuated by self-rated health and physical activity. The study underscores the importance of SWB for health and longevity, particularly for older adults.
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1016/J.APPET.2015.01.002
Abstract: Dietary behaviours are substantially influenced by environmental and internal stimuli, such as mood, social situation, and food availability. However, little is known about the role of stimulus control for eating in non-clinical populations, and no studies so far have looked at eating and drinking behaviour simultaneously. 53 in iduals from the general population took part in an intensive longitudinal study with repeated, real-time assessments of eating and drinking using Ecological Momentary Assessment. Eating was assessed as main meals and snacks, drinks assessments were separated along alcoholic and non-alcoholic drinks. Situational and internal stimuli were assessed during both eating and drinking events, and during randomly selected non-eating occasions. Hierarchical multinomial logistic random effects models were used to analyse data, comparing dietary events to non-eating occasions. Several situational and affective antecedents of dietary behaviours could be identified. Meals were significantly associated with having food available and observing others eat. Snacking was associated with negative affect, having food available, and observing others eat. Engaging in activities and being with others decreased the likelihood of eating behaviours. Non-alcoholic drinks were associated with observing others eat, and less activities and company. Alcoholic drinks were associated with less negative affect and arousal, and with observing others eat. RESULTS support the role of stimulus control in dietary behaviours, with support for both internal and external, in particular availability and social stimuli. The findings for negative affect support the idea of comfort eating, and results point to the formation of eating habits via cue-behaviour associations.
Publisher: Wiley
Date: 18-03-2019
DOI: 10.1111/APHW.12154
Abstract: Dietary behaviours are strongly patterned by socioeconomic status (SES). However, the role of SES in the self-regulation of health promoting dietary behaviours is not fully understood. This systematic review with meta-analysis investigated whether four in idual-level measures of SES (income, occupation, education, and ethnicity) moderate the relationships between Theory of Planned Behaviour (TPB) variables and different health promoting dietary behaviours in adults. A systematic literature search identified 106 studies from 77 articles providing information on TPB variables, SES, and health promoting dietary behaviours-choosing health promoting foods and restricting health compromising foods. Random-effects meta-analyses were conducted to generate pooled correlations corrected for s ling and measurement error, and meta-regression was used to test moderating effects of study-level SES. All TPB variables were significantly and positively associated with both health promoting dietary behaviours, with intention having the strongest correlation with behaviour. However, none of the relationships between TPB variables and health promoting dietary behaviours were significantly moderated by study-level SES. Results suggest robust associations between TPB predictors and healthy dietary behaviour that are not patterned by in idual-level SES measures.
Publisher: Center for Open Science
Date: 20-08-2020
Abstract: Background: Socioeconomic differences in health-related behaviors are a major cause ofhealth inequalities. However, the mechanisms (mediation / moderation) by which socioeconomic status (SES) affects health behavior are a topic of ongoing debate.Purpose: Current research on SES as moderator of the health cognitions - health behavior relation is inconsistent. Previous studies are limited by erse operationalizations of SES and health behaviors, demographically narrow s les, and between-person designs addressing within-person processes. This paper presents two studies addressing these shortcomings in a within-person multi-behavior framework using hierarchical linear models.Methods: Two online studies, one cross-sectional and one 4-week longitudinal, assessed 1,005 (Study 1 Amazon MTurk US only) and 1,273 participants (Study 2 Prolific international). Self-reports of multiple SES indicators (education, income, occupation status ZIP code in Study 1), health cognitions (from the Theory of Planned Behavior) and measures of 6 health behaviors were taken. Multilevel models with cross-level interactions tested wither the within-person relationships between health cognitions and behaviors differed by between-person SES .Results: Education significantly moderated intention-behavior and attitude-behavior relationships in both studies, with more educated in iduals showing stronger positive relationships. In addition, ZIP-level SES (Study 1) moderated attitude-behavior effects such that these relationships were stronger in participants living in areas with higher SES. Conclusions: Education appears to be an important resource for the translation of intentions and attitudes into behavior. Other SES indicators showed less consistent effects. This has implications for interventions aiming at increasing intentions to change health behaviors, as some interventions might inadvertently increase health inequalities.
Publisher: American Psychological Association (APA)
Date: 2016
DOI: 10.1037/PAG0000064
Abstract: Retaining perceptions of autonomy is a key component of successful aging. Perceived autonomy refers to the capacity to make and enact self-directed decisions. These perceptions are often threatened in older adults with multiple illnesses, when functional limitations resulting from these illnesses impede the enactment of self-directed decisions. Regional resources (in Germany specifically at the level of administrative districts) might counteract these impediments of autonomy. Economically stronger districts can provide more-concrete support resources for older adults, buffering the negative effect of functional limitations on self-perceived autonomy. This study assessed participants aged over 65 with 2 or more chronic conditions. In total, N = 287 provided data (Mage = 73.3, SD = 5.07), and n = 97 were women. Gross domestic product (GDP) per capita was used as a proxy measure of administrative district wealth in Germany. Hierarchical multilevel regression analyses with cross-level interactions were conducted. Results suggest that the detrimental effect of functional limitations on perceived autonomy is less pronounced for participants residing in higher GDP districts. Conversely, for participants in lower GDP districts, the effect is exacerbated. This finding suggests that districts with greater financial resources might be better able to invest in supports that promote and facilitate autonomy and, thus, provide a buffer against threats to in idual perceived autonomy.
Publisher: SAGE Publications
Date: 14-06-2010
Abstract: Health education interventions can be tailored toward stages of change. This strategy is based on theories that predict at which stage which variables are indicative of subsequent behavior change processes. For ex le, planning is regarded as being effective in intenders. However, rather few studies have tested whether matched interventions are more successful for stage transitions than mismatched ones. Also very few previous studies have identified specific variables as targets of stage-matched interventions. A 2 (condition) × 2 (stages) experimental study tested the effects of stage-matched interventions for 226 participants. The stage-matched intervention moved significantly more in iduals forward to action than did the control condition. Stage-specific effects were found to corroborate 78% of the assumptions. Multiple mediator analyses revealed stage-specific mechanisms, indicating that intention and planning facilitated behavior change in intenders. Thus, health behavior interventions should take stages of change into account.
Publisher: Center for Open Science
Date: 19-10-2020
Abstract: Background: Socioeconomic differences in health-related behaviors are a major cause ofhealth inequalities. However, the mechanisms (mediation / moderation) by which socioeconomic status (SES) affects health behavior are a topic of ongoing debate.Purpose: Current research on SES as moderator of the health cognitions - health behavior relation is inconsistent. Previous studies are limited by erse operationalizations of SES and health behaviors, demographically narrow s les, and between-person designs addressing within-person processes. This paper presents two studies addressing these shortcomings in a within-person multi-behavior framework using hierarchical linear models.Methods: Two online studies, one cross-sectional and one 4-week longitudinal, assessed 1,005 (Study 1 Amazon MTurk US only) and 1,273 participants (Study 2 Prolific international). Self-reports of multiple SES indicators (education, income, occupation status ZIP code in Study 1), health cognitions (from the Theory of Planned Behavior) and measures of 6 health behaviors were taken. Multilevel models with cross-level interactions tested wither the within-person relationships between health cognitions and behaviors differed by between-person SES .Results: Education significantly moderated intention-behavior and attitude-behavior relationships in both studies, with more educated in iduals showing stronger positive relationships. In addition, ZIP-level SES (Study 1) moderated attitude-behavior effects such that these relationships were stronger in participants living in areas with higher SES. Conclusions: Education appears to be an important resource for the translation of intentions and attitudes into behavior. Other SES indicators showed less consistent effects. This has implications for interventions aiming at increasing intentions to change health behaviors, as some interventions might inadvertently increase health inequalities.
Publisher: Oxford University Press (OUP)
Date: 22-11-2014
DOI: 10.1007/S12160-014-9671-2
Abstract: Illness perceptions predict important outcomes, e.g. coping, adherence and well-being. Less is known about the sources of illness perceptions, in particular the role of environmental factors such as primary care supply. This study examines whether and how primary care supply (on district level) affects in idual illness perceptions. We conducted a longitudinal study in 271 adults 65 years and older with multiple illnesses. Functional limitations (SF-36 physical functioning subscale) at time 1 were tested as predictors of illness perceptions 6 months later. Primary care supply on district level was matched to in idual data. In multilevel models, functional limitations predicted illness perceptions. Primary care supply on district level moderated the impact of functional limitations on in idual identity and emotional response perceptions, with better supply buffering detrimental effects of functional limitations. Illness perceptions do not only depend on in idual factors, but socio-structural factors also substantially contribute to in idual illness perceptions.
Publisher: Elsevier BV
Date: 09-2021
Publisher: Springer Science and Business Media LLC
Date: 21-04-2011
DOI: 10.1007/S11136-011-9909-4
Abstract: Self-rated health (SRH) is widely regarded a valid and reliable indicator of health status. The validity of self-rated health has been demonstrated in many studies, for ex le by predicting mortality over and above medical and epidemiological data. However, the meaning of SRH can differ between in iduals, especially in elderly in iduals with considerable in idual differences in their physical health states. It is thus important to determine whether predictors of self-rated health vary according to physical health status in order to interpret self-rated health data. In a representative survey study, 1174 in iduals over 65 years of age rated their health and filled in questionnaires on subjective well-being, control beliefs, depressive symptoms, and functional health. Structural equation modeling with latent moderated structural equations was used to determine whether health status (number of illnesses) moderated the association of self-rated health with these predictors. Self-rated health was predicted by positive affect, depressive symptoms, control beliefs, and physical functioning. Moderated effects were found for positive affect and physical functioning, suggesting that there are stronger associations with positive affect in healthier in iduals and stronger associations with physical functioning in less healthy in iduals. This implies that SRH has differential associations depending on health status, which should be taken into account in interpreting any research with SRH as predictor or criterion.
Publisher: Wiley
Date: 21-08-2016
DOI: 10.1002/PON.4213
Abstract: Cancer is associated with negative health and emotional outcomes in those affected by it, suggesting the need to better understand the psychosocial determinants of illness outcomes and coping. The common sense model is the leading psychological model of self-regulation in the face of illness and assumes that subjective illness representations explain how people attempt to cope with illness. This systematic review and meta-analysis examines the associations of the common sense model's illness representation dimensions with health and coping outcomes in people with cancer. A systematic literature search located 54 studies fulfilling the inclusion criteria, with 38 providing sufficient data for meta-analysis. A narrative review of the remaining studies was also conducted. Random-effects models revealed small to moderate effect sizes (Fisher Z) for the relations between illness representations and coping behaviors (in particular between control perceptions, problem-focused coping, and cognitive reappraisal) and moderate to large effect sizes between illness representations and illness outcomes (in particular between identity, consequences, emotional representations, and psychological distress). The narrative review of studies with insufficient data provided similar results. The results indicate how illness representations relate to illness outcomes in people with cancer. However, more high-quality studies are needed to examine causal effects of illness representations on coping and outcomes. High heterogeneity indicates potential moderators of the relationships between illness representations and health and coping outcomes, including diagnostic, prognostic, and treatment-related variables. This review can inform the design of interventions to improve coping strategies and mental health outcomes in people with cancer.
Publisher: MDPI AG
Date: 22-06-2022
DOI: 10.3390/ANTIBIOTICS11070836
Abstract: A comprehensive small area description of regional variations in outpatient antibiotic prescribing in Germany is lacking. Using the German Pharmacoepidemiological Research Database (GePaRD), a claims database covering ~20% of the German population, we determined the age- and sex-standardized prescription rates of antibiotics (number of outpatient prescriptions per 1000 persons/year). We calculated these prescription rates overall and on the level of 401 German districts for the calendar years 2010 and 2018. In 2018, the standardized prescription rate of antibiotics in the total study population was 23% lower than in 2010 (442 vs. 575 per 1000 persons/year). Among 0–17-year-olds, prescription rates across districts ranged from 312 to 1205 in 2010 and from 188 to 710 in 2018 per 1000 persons/year among adults (≥18 years), they ranged from 388 to 841 in 2010 and from 300 to 693 in 2018 per 1000 persons/year. Despite the overall decline in outpatient antibiotic prescribing between 2010 and 2018, regional variations at the district level remained high in all age groups in Germany. Identifying reasons that explain the persistently high prescription rates in certain regions will be helpful in designing effective and tailored measures to further improve antibiotic stewardship in these regions.
Publisher: Springer Science and Business Media LLC
Date: 20-03-2013
DOI: 10.1007/S10865-013-9504-Y
Abstract: Health motives are motivational dispositions towards health. They are implicitly inherent in most health behaviour theories, yet rarely studied. We examined the role of health motives in health behaviour self-regulation (physical activity), particularly in the mediation of intention effects on behaviour via planning in an at-risk population with high need for behaviour change, older adults with multiple illnesses. A longitudinal study with two measurement points over 6 months was conducted, assessing 309 community-dwelling adults with multiple illnesses aged 65 and older. Health motives were assessed by contrasting health ratings with all other domains on the Personal Life Investment Schedule. Data were analysed in a moderated mediation framework using path analyses. Health Motives moderated the degree to which intentions predicted behaviour via planning (intention*health motives β = .18, p < .05). Intentions are better translated into planning and behaviour if furnished with health motives. For older adults, this suggests that "health" in health behaviour change motivation merits more investigation, for ex le by stressing functional implications.
Publisher: Oxford University Press (OUP)
Date: 06-2007
DOI: 10.1007/BF02879897
Publisher: Wiley
Date: 06-2008
DOI: 10.1111/J.1539-6924.2008.01047.X
Abstract: This study examined the relation between health behavior and risk perceptions in the context of an acute livestock epidemic. Participants in a longitudinal web-based survey (N= 195) were asked to report their meat consumption and their perceived risk in relation to bovine spongiform encephalopathy (BSE) and other related livestock diseases. Cross-sectional analyses at both measurement points (T1 and T2) showed that participants with low levels of preventive nutrition (high meat consumption) felt more at risk for BSE-related diseases than those reporting comparable higher levels of preventive behavior (low meat consumption), indicating relative accuracy. These results suggest that people recognize when their behavior is risky. More importantly, perceived risk also showed adaptive accuracy from a change perspective: increases in preventive nutrition from T1 to T2 were significantly associated with decreases in perceived risk between T1 and T2. Possible foundations and implications of an adaptive accuracy of risk perceptions are discussed.
Publisher: Elsevier BV
Date: 2018
Publisher: SAGE Publications
Date: 07-05-2010
Abstract: Can latent true changes in intention, planning, and self-efficacy account for latent change in two health behaviors (physical activity as well as fruit and vegetable intake)? Baseline data on predictors and behaviors and corresponding follow-up data four weeks later were collected from 853 participants. Interin idual differences in change and change—change associations were analyzed using structural equation modeling. For both behaviors, similar prediction patterns were found: changes in intention and self-efficacy predicted changes in planning, which in turn corresponded to changes in behavior. This evidence confirms that change predicts change, which is an inherent precondition in behavior change theories.
Publisher: SAGE Publications
Date: 05-11-2012
Abstract: Life satisfaction and control beliefs are established indicators of successful aging and predict mortality. However, it has not yet been examined whether they independently predict mortality or interact. We examined main and interaction effects using Cox proportional hazards models in a s le of older adults ( N = 1402 age range: 65–91). Only the interaction of life satisfaction and control beliefs significantly predicted mortality when controlling for socio-demographic variables and health. These findings suggest that detrimental effects of low control beliefs can be buffered by life satisfaction, and unexpectedly, that high levels of both factors are not most protective against mortality.
Publisher: Oxford University Press (OUP)
Date: 07-2020
DOI: 10.1093/ABM/KAZ023
Abstract: Socioeconomic differences in health-related behaviors are a major cause of health inequalities. However, the mechanisms (mediation/moderation) by which socioeconomic status (SES) affects health behavior are a topic of ongoing debate. Current research on SES as moderator of the health cognitions–health behavior relation is inconsistent. Previous studies are limited by erse operationalizations of SES and health behaviors, demographically narrow s les, and between-person designs addressing within-person processes. This paper presents two studies addressing these shortcomings in a within-person multibehavior framework using hierarchical linear models. Two online studies, one cross-sectional and one 4 week longitudinal, assessed 1,005 (Study 1 Amazon MTurk USA only) and 1,273 participants (Study 2 Prolific international). Self-reports of multiple SES indicators (education, income, occupation status ZIP code in Study 1), health cognitions (from the theory of planned behavior), and measures of six health behaviors were taken. Multilevel models with cross-level interactions tested whether the within-person relationships between health cognitions and behaviors differed by between-person SES. Education significantly moderated intention-behavior and attitude-behavior relationships in both studies, with more educated in iduals showing stronger positive relationships. In addition, ZIP-level SES (Study 1) moderated attitude-behavior effects such that these relationships were stronger in participants living in areas with higher SES. Education appears to be an important resource for the translation of intentions and attitudes into behavior. Other SES indicators showed less consistent effects. This has implications for interventions aiming at increasing intentions to change health behaviors, as some interventions might inadvertently increase health inequalities.
Publisher: American Psychological Association (APA)
Date: 05-2011
DOI: 10.1037/A0022514
Abstract: This study examined whether socioeconomic status (SES) determines the degree to which psychological and social resources such as optimistic self-beliefs and social support affect health. We used data from the representative German Ageing Survey (N = 2,454, aged 40-85 years). Structural equation modeling was employed to examine whether relationships between psychological (self-esteem, control beliefs, optimism) and social resources (perceived emotional and informational support, network size) and health differ between education and income groups. Self-reported physical health, functional health, and subjective health. Psychological resources positively affected health in all groups but were stronger predictors of functional and subjective health in low compared to higher educated participants. A higher level of social resources was associated with better functional and subjective health mainly in the low-income group. Social resources were particularly important for financially disadvantaged older people. Our results provide evidence for differential effects of optimistic self-beliefs and social support on health depending on whether in iduals are challenged by low incomes or low education. Future research, especially aimed at intervention, should consider that different aspects of SES have differential meanings and that the impact of health-protective factors may vary according to SES facet.
Publisher: Wiley
Date: 2005
DOI: 10.1002/EJSP.258
Publisher: JMIR Publications Inc.
Date: 21-08-2019
Abstract: t has been observed that eating is influenced by the presence and availability of food. Being aware of the presence of food in the environment may enable mobile health (mHealth) apps to use geofencing techniques to determine the most appropriate time to proactively deliver interventions. To date, however, studies on eating typically rely on self-reports of environmental contexts, which may not be accurate or feasible for issuing mHealth interventions. his study aimed to compare the subjective and geographic information system (GIS) assessments of the momentary food environment to explore the feasibility of using GIS data to predict eating behavior and inform geofenced interventions. n total, 72 participants recorded their food intake in real-time for 14 days using an ecological momentary assessment approach. Participants logged their food intake and responded to approximately 5 randomly timed assessments each day. During each assessment, the participants reported the number and type of food outlets nearby. Their electronic diaries simultaneously recorded their GPS coordinates. The GPS data were later overlaid with a GIS map of food outlets to produce an objective count of the number of food outlets within 50 m of the participant. orrelations between self-reported and GIS counts of food outlets within 50 m were only of a small size ( i r /i =0.17 i P /i & .001). Logistic regression analyses revealed that the GIS count significantly predicted eating similar to the self-reported counts (area under the curve for the receiver operating characteristic curve [AUC-ROC] self-report=0.53, SE 0.00 versus AUC-ROC 50 m GIS=0.53, SE 0.00 i P /i =.41). However, there was a significant difference between the GIS-derived and self-reported counts of food outlets and the self-reported type of food outlets (AUC-ROC self-reported outlet type=0.56, SE 0.01 i P /i & .001). he subjective food environment appears to predict eating better than objectively measured food environments via GIS. mHealth apps may need to consider the type of food outlets rather than the raw number of outlets in an in idual’s environment.
Start Date: 2016
End Date: 2016
Funder: The Sax Institute
View Funded ActivityStart Date: 2016
End Date: 2016
Funder: University of Tasmania
View Funded ActivityStart Date: 2016
End Date: 2016
Funder: University of Tasmania
View Funded ActivityStart Date: 2013
End Date: 2013
Funder: WorkCover Tasmania
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