Attitudinal Interventions Research Articles

A Scoping Review of Workplace Interventions to Promote Positive Attitudes Toward Older Workers and Reduce Age-Based Discrimination

Abstract Population aging trends have created a need for effective policies to extend adult working lives. Previous research has identified the prevalence of negative attitudes (age-related stereotypes, prejudice, and discriminatory behaviors) directed toward older workers in the workplace context. The current scoping review aimed to describe and assess the current evidence in support of different types of interventions aimed at promoting positive attitudes and reducing age-based discrimination in the workplace context. A search of peer-reviewed and grey literature databases identified 22 relevant studies, including data from 5,078 adult participants, across laboratory and field settings. From examination of these studies, we propose and describe four thematic categories of interventions, as a way of organizing this literature: “de-biasing interventions,” “brief attitudinal interventions,” “age diversity workshop interventions,” and “structural or contextual interventions.” At the current point in time, studies assessing age diversity workshop interventions appear to be the strongest, having a clear theoretical basis, having a focus on interventions that can be delivered in workplace settings, and providing evidence for positive effects on measures that are meaningful for organizations and older workers. While a number of promising interventions have been tested, most studies were only able to demonstrate improvements in explicit measurements of attitudes toward older adults, immediately following the intervention. Collaborative partnerships with organizations and further high-quality studies (particularly in field settings) are required to support the development, evaluation, and implementation of interventions to promote positive attitudes toward older adults in real-world workplace settings.

A COMPARISON OF CURRENT ATTITUDE TOWARDS PSYCHIATRY AMONG FIRST YEAR AND FINAL YEAR MBBS STUDENTS IN A MEDICAL COLLEGE OF EASTERN PART OF INDIA

Background: Psychiatry in recent years has seen a lot of progress especially in the areas of neurobiology, neuroimaging and social sciences. To ensure proper care of psychiatric patients, young, passionate and open-minded doctors are definitely the need of the hour. Psychiatry has been included as a subject in final year MBBS students’ curriculum. Aims: To compare the attitude of the first and final year undergraduate MBBS students towards psychiatry. Methods: This is a cross-sectional analytical study conducted with the undergraduate students of first year and final year MBBS. “The pro forma enlisting the details of the demographic data and Attitude Towards Psychiatry scale (ATP-30) was given out to each participant after taking informed consent. “The qualitative data were depicted in terms of percentages and the quantitative data were expressed in terms of Mean + SD. The statistics were done using IBM SPSS 20V. Results: The mean ATP-30 score that was found to be higher for final year MBBS students (114.48+10.084) than first year students (83.93+11.083) although it was statistically insignificant (p=.117). Two item questionnaire, “Psychiatric patients are often more interesting to work with than other patients” and “It is quite easy for me to accept the efficacy of psychotherapy” had a higher mean score for final year students than the first year students that was significant statistically. Conclusion: Our study suggests the requirement to revise the current curriculum of psychiatry training imparted to the undergraduate students. Strategies like attitudinal interventions and de-stigmatization must be more focused.

A comparative study of relative roles and sequences of cognitive and affective attitudes on tourists’ pro-environmental behavioral intention

Attitudinal interventions are commonly implemented to nudge pro-environmental actions. However, the relative roles and sequences of cognitive and affective attitudes on tourists’ pro-environmental behavioral intention (PEBI) and how PEBI variants impact the attitude-intention relationships require further investigation. Based on the theory of planned behavior, this paper compares the differential effects and sequences of cognitive and affective attitudes on tourists’ low-effort and high-effort PEBI. Structural equation modeling results of two studies conducted in a nature-based and an urban destination showed a superior role of affect, i.e., affective, but not cognitive attitude, guided tourists’ PEBI, irrespective of implementation difficulty variants. This finding supports the automatic-processing rather than the controlled-processing hypothesis of attitude-intention processes in the tourism context. The results of sequential models further confirmed the above conclusion and supported the “affective” model wherein affective attitude predicts cognitive attitude when shaping subsequent PEBI. These studies advance understandings of relationships between and sequences of attitudes and PEBIs and challenge predominant cognitive interventions in environmental communication practices.

Temporal effectiveness of interventions to improve medication adherence: A network meta-analysis.

IntroductionAdherence-enhancing interventions have been assessed in the literature, however heterogeneity and conflicting findings have prohibited a consensus on the most effective approach to maintain adherence over time. With the ageing population and growth of chronic conditions, evaluation of sustainable strategies to improve and maintain medication adherence long term is paramount. We aimed to determine the comparative effectiveness of interventions for improving medication adherence over time among adults with any clinical condition.Materials and methodsMeta-analyses evaluating interventions to improve medication adherence were searched in PubMed in January 2019 and reviewed for primary studies. Experimental studies with a comparison group assessing an intervention to enhance medication adherence in adult patients with reported adherence outcomes were included. Two authors extracted data for study characteristics, interventions and adherence outcomes. Interventions were categorized into four groups or combinations: educational, attitudinal, technical and rewards. Four network meta-analyses were performed to compare interventions based on patient follow-up time. Medication adherence effect sizes were reported as odds ratios (OR) with a 95% credibility interval (CrI) and surface under the cumulative ranking curve (SUCRA) to allow ranking probabilities. Risk of bias was assessed as per Cochrane guidelines.ResultsData was obtained from 69 meta-analyses with 468 primary studies being included in qualitative synthesis. The four networks compromised of 249 studies in total (0–3 month follow-up: 99 studies, 4–6 months: 104, 7–9 months: 18, ≥10 months: 94). Interventions showing success in follow-ups of less than 10 months varied across time. Significant effects compared to standard of care (SOC) were found in technical (4–6 months: OR 0.34, 95% CrI 0.25–0.45) and attitudinal interventions (7–9 months: 0.37, 0.17–0.84). Multicomponent interventions demonstrated effectiveness compared to standard of care with an additive effect displayed, particularly in longer follow-ups (educational + attitudinal + technical interventions ≥10 months: OR 0.49, 95% CrI 0.27–0.88).DiscussionAll interventions reviewed improved medication adherence compared to standard of care. Multicomponent interventions displayed the most promising results in maintenance of long-term medication adherence. Technical and reward components enhanced adherence on a short-term basis, while educational and attitudinal interventions evolved over time to be more effective in follow-ups greater than 7 months. Sustainability of adherence to medications over time is dependent upon multicomponent interventions including educational, attitudinal and technical aspects to modify and enhance patient medication-taking behavior. Future research should focus on the most cost-effective approaches able to be integrated into routine practice.

Comparison of Interventions to Improve Long-Term Medication Adherence Across Different Clinical Conditions: A Systematic Review With Network Meta-Analysis

Background: Medication non-adherence has a dynamic, temporal and multifactorial nature with a significant impact on economic and clinical outcomes. Interventions to improve adherence are complex and require adaptation to patients' needs, which may include patient's medical conditions. The aim of this study was to assess the comparative effectiveness of medication adherence interventions per type of clinical condition on adult patients.Methods: A systematic review with network meta-analysis was performed (PROSPERO registration number of CRD42018054598). An initial Pubmed search was conducted to select meta-analyses reporting results of interventions aiming to improve medication adherence. Primary studies were selected and those reporting results with a long-term follow up (≥10 months) on adult patients were included for data extraction. Study characteristics, description of interventions and adherence outcomes were extracted. Adherence interventions were classified in four groups: educational, attitudinal, technical, and rewards. Clinical conditions were classified in four groups: circulatory system and metabolic diseases, infectious diseases, musculoskeletal diseases, and mental, behavioral or neurodevelopmental disorders. Network meta-analyses with effect sizes expressed as odds ratio (OR) with a 95% credibility interval (CrI) were built. Ranking probabilities for each measure of adherence were calculated by using surface under the cumulative ranking analysis (SUCRA).Results: A total of 61 meta-analysis and 149 primary studies were included in the qualitative synthesis and 80 primary studies in the quantitative analysis. The most effective interventions were: educational + technical 79.6% [OR: 0.44 (CrI: 0.26, 0.73)] and 73.3% [OR: 0.56 (0.36, 0.84)] in circulatory system and metabolic diseases and infectious diseases respectively. Attitudinal intervention had the greatest probability for musculoskeletal diseases of 92.3% in SUCRA [OR: 0.30 (0.10, 0.86)]. Finally, educational + attitudinal interventions had the greatest effect (SUCRA 73.8%) for mental, behavioral or neurodevelopmental disorders, although this was not significant according to consistency analysis.Conclusion: Effectiveness of interventions seems to be related to the clinical condition. Educational and technical interventions resulted in a major effect on long-term management of medication adherence in patients with infectious diseases (HIV) and circulatory system and metabolic diseases whereas attitudinal components presented a higher effect on musculoskeletal and mental, behavioral or neurodevelopmental disorders.

Reducing Stigma and Punitive Attitudes Toward Pedophiles Through Narrative Humanization.

Stigmatization and societal punitiveness about pedophilia have a range of potential consequences, such as the social isolation of people with sexual interest in children, and the formation of policies that are not consistent with empirical research findings. Previous research has shown that people with pedophilic sexual interests use societal thinking to self-stigmatize, which in turn may actually serve to increase their risk of committing a sexual offense. In this study, we compared two attitudinal interventions (first-person narrative vs. expert opinion) using a student sample ( N = 100). It was hypothesized that both interventions would lead to reductions in stigmatization and punitive attitudes about pedophiles on an explicit (self-report) level but that only the narrative intervention would lead to reductions of these constructs at the implicit level. Our findings supported both hypotheses. We further discuss the role of narrative humanization in this area and offer suggestions for further research based upon the theoretical and methodological implications of the findings.

U-FADE

Although persuasive technology continues to impact behavioural and attitudinal interventions, research has demonstrated that existing design approaches are faced with limitations that impede their effective use. Mostly, they become obsolete, as user needs change during the use of the persuasive application. This research therefore proposes the Unified Framework for Analysing, Designing and Evaluating persuasive systems (U-FADE). The proposed framework integrates concepts from various existing models to provide a systematic approach that facilitates persuasive design. It addresses the issue of changing needs of users by considering external and internal activities that may promote or impede persuasion before and during implementation.

Determining factors in evidence‐based clinical practice among hospital and primary care nursing staff

The general aim of this study is to identify key factors perceived by nurses to influence evidence-based clinical practice at different centres. During the last decade, there has been an increased interest in the identification of factors that facilitate the transfer of knowledge into clinical practice, among health care professionals. Previous research states that a suitable organisational framework and practice environment seems to have influence on a greater use of scientific evidence by nurses, which can be directly observed in patient outcomes. In consequence, several authors suggest that strategies should be encouraged from managers and nurse executives to guarantee the existence of environments that avoid emotional exhaustion and improve satisfaction of nurses with their work, and at the same time, ensure the use of research-guided nursing decisions. Following the Spanish validation of the Practice Environment Scale-Nursing Work Index and Evidence Based Practice Questionnaire, a descriptive observational cross-sectional study has been conceived, from 2010 to 2011, in order to identify determining factors in evidence-based clinical practice at different centres. In a second phase, a qualitative study has been designed, using focus groups, to identify practice factors that can lead to a successful implementation of evidence-based clinical practice. Organisational and attitudinal interventions are needed in order to implement evidence-based clinical practice that improves the quality of patient care.

Attitudinal and Demographic Predictors of Measles-Mumps-Rubella Vaccine (MMR) Uptake during the UK Catch-Up Campaign 2008–09: Cross-Sectional Survey

Background and ObjectiveContinued suboptimal measles-mumps-rubella (MMR) vaccine uptake has re-established measles epidemic risk, prompting a UK catch-up campaign in 2008–09 for children who missed MMR doses at scheduled age. Predictors of vaccine uptake during catch-ups are poorly understood, however evidence from routine schedule uptake suggests demographics and attitudes may be central. This work explored this hypothesis using a robust evidence-based measure.DesignCross-sectional self-administered questionnaire with objective behavioural outcome.Setting and Participants365 UK parents, whose children were aged 5–18 years and had received <2 MMR doses before the 2008–09 UK catch-up started.Main Outcome MeasuresParents' attitudes and demographics, parent-reported receipt of invitation to receive catch-up MMR dose(s), and catch-up MMR uptake according to child's medical record (receipt of MMR doses during year 1 of the catch-up).ResultsPerceived social desirability/benefit of MMR uptake (OR = 1.76, 95% CI = 1.09–2.87) and younger child age (OR = 0.78, 95% CI = 0.68–0.89) were the only independent predictors of catch-up MMR uptake in the sample overall. Uptake predictors differed by whether the child had received 0 MMR doses or 1 MMR dose before the catch-up. Receipt of catch-up invitation predicted uptake only in the 0 dose group (OR = 3.45, 95% CI = 1.18–10.05), whilst perceived social desirability/benefit of MMR uptake predicted uptake only in the 1 dose group (OR = 9.61, 95% CI = 2.57–35.97). Attitudes and demographics explained only 28% of MMR uptake in the 0 dose group compared with 61% in the 1 dose group.ConclusionsCatch-up MMR invitations may effectively move children from 0 to 1 MMR doses (unimmunised to partially immunised), whilst attitudinal interventions highlighting social benefits of MMR may effectively move children from 1 to 2 MMR doses (partially to fully immunised). Older children may be best targeted through school-based programmes. A formal evaluation element should be incorporated into future catch-up campaigns to inform their continuing improvement.

Situation-Specific Assertiveness in the Epidemiology of Sexual Victimization Among University Women

Protective and risk factors for sexual victimization were examined in a sample of 274 undergraduate women. Assertiveness specific to situations with the opposite gender was protective at all three assessment times. Prior victimization, alcohol use, poor adjustment (as indicated by depression and anxiety), multiple sexual partners, and insecurity about relationships with the opposite gender were significant risk factors. Prevention efforts might be more effective if (a) behavioral practice of assertiveness was added to informational and attitudinal interventions; (b) assertiveness training focused specifically on relationships with the opposite gender; (c) medical and counseling services routinely assessed for prior victimization and other risk factors, and made appropriate referrals for women with victimization histories; and (d) alcohol education-programs were integrated with acquaintance-rape programs.