Cons Of Change Research Articles

Engaging Youth (Adolescents and Young Adults) to Change Frequent Marijuana Use: Motivational Enhancement Therapy (MET) in Primary Care

PurposeTo characterize information elicited from adolescent/young adults with frequent cannabis use in Motivational Enhancement Therapy (MET), and determine whether differences exist across stages of change (SOC) for reducing use. Design and methodsPrimary care patients 15–24 years old using cannabis ≥3 times/week enrolled in a pilot randomized intervention trial. All youth were offered two 1-hour MET sessions. Content analysis was used to code and categorize main reasons for use, alternative behaviors, goals, values, pros and cons of change, and compared results between youth in Pre-Contemplation vs. Contemplation SOC. ResultsFifty-six youth completed MET session 1, 46 completed session 2. Most reported their main reason for use was related to emotional coping, negative feelings were a top-3 trigger, and distraction was an alternative way to meet their needs. Youth most frequently described progress in education or career/job as 1-year goals. More than half identified family as a very important value. They most frequently reported pros of using less related to achieving goals, self-improving, and saving money, and a con related to stress/coping. Compared to youth in Pre-Contemplation SOC, those in Contemplation were more likely to identify relationships as both a pro and con of using less cannabis. ConclusionsMET can reveal developmentally appropriate goals, healthy values, and ambivalence about cannabis use that can be used to facilitate movement along the stages of behavior change toward reduction/cessation. Practice implicationsBrief motivational therapy can be used in primary care to gather information important in helping youth to reduce cannabis use.

The effectiveness of a model-based health education intervention to improve ergonomic posture in office computer workers: a randomized controlled trial.

Lack of knowledge about computer ergonomics predisposes users to musculoskeletal and visual disorders. The present study examined the effect of a trans-theoretical model (TTM)-based educational program on work-related posture in office computer users. This experimental study examined 102 hospital personnel whose primary job involved working at a computer. Participants were randomized to intervention and control groups. An educational intervention based on TTM was conducted over five sessions. A self-report questionnaire was used to collect data including stages of change, processes of change, pros and cons of change, and self-efficacy. A pen-paper-based observational method (i.e., Rapid Office Strain Assessment or ROSA) was used for assessing work posture. A visual analogue scale assessed pain intensity. Data were collected at baseline and 3-month follow-up. Significant differences were found on TTM's constructs and ROSA score between intervention and control groups at follow-up (p < 0.05). The mean ROSA score decreased from 5.65 (SD 1.03) to 3.95 (SD 0.83) in the intervention group, while no significant change was found in the control group. Pain intensity also decreased significantly among those in the intervention vs. control group (p < 0.001). An educational intervention based on TTM was effective in improving ergonomic posture in computer workers. Further research is needed to determine if these results can be generalized to computer workers in other settings.

The Right and the Good: Communicating Environmental Issues

What we see is partially dependent on what we are shown. As communicators, we have a duty to inform and educate and lead. As environmental communicators we have the privilege of explaining how the various parts of our natural world work, individually, in unison, and in relationship to people. By examining two specific areas of growing global concerns, this paper provides an analytic tool and starts a discussion as to what should be guiding decisions concerning major environmental questions. The first growing global concern discussed is tailings ponds in Northern Alberta’s oil sands. The second is the large bodies of air pollution in Asia. In both cases, (Good) short term decisions that benefit a few have led to large environmental concerns. Should humanity be worried about our future? Could (Right) long-term, sustainable, and inclusive decisions lead to more manageable environmental challenges? To be a communicator in the real world it is important to know and differentiate between the Good and the Right. Good and Right communications in environmental issues support daily or frequent acts concerning any or all of three critical areas: sustainability, conservation, and climate change. Questions are addressed. Where are people now with respect to environment, how did we get here, and what are the pros and cons of changing from Good to Right solutions? By looking at one individual’s choice, readers see that Good and Right decisions do not have to be mutually exclusive.

Boosting M&amp;A Transactions in CEE Region

Considering the last 2 calendar years, the M&A Market in CEE Region is very active. The M&A market measured by volume of transactions almost doubled year-on-year and trend is expected to continue in following months. This is based on few large transactions completed very recently. But on the other hand, there is large activity in the area of smaller transactions as well. Comparing with the rest of the Europe, the trend is completely different. The cumulated volume as well as the number of transactions is constantly decreasing. What is behind the increased M&A activity in CEE Region? Why CEE Region is so different from rest of EU? This article tries to gives reader a better understanding of the situation in the region in terms of M&A activity and the background and what are the prospects in terms of future activity in selling and buying companies. The author has had an ambition to analyze the factors influencing these 3 critical incentives leading to changes acquisition appetite as well as pros and cons of changes in the companies’ shareholding.

Food for thought: A pilot study of the pros and cons of changing eating patterns within cognitive-behavioural therapy for the eating disorders

Evidence-based cognitive-behavioural therapy (CBT) for the eating disorders has an early focus on behavioural changes around food intake. However, patients' anxiety around such change might account for why they often seem unmotivated in treatment. In order to determine the impact of changing intake, this pilot study of patients with bulimic disorders (N = 19) or anorexia nervosa (N = 9) used a mixed quantitative and qualitative design to retrospectively examine their perspectives of the short- and long-term pros and cons of such change. As expected, change was seen negatively in the short-term (with particularly high numbers reporting anxiety), but there were few reports of long-term negative outcomes. In contrast, there were both short- and long-term benefits of changing eating. The patients described what was helpful in making changes and what they had learned as a result. In both cases, their descriptions mapped closely onto the content and process of evidence-based CBT for the eating disorders. Although there is a need for more extensive research, these findings suggest that patients (and therapists) might benefit from being aware of the contrast between the short- and the long-term pros and cons of changing eating within CBT for the eating disorders.

Drug Abuse by Adolescents: General Considerations

1. Ximena Sanchez-Samper, MD* 2. John R. Knight, MD* 1. *Center for Adolescent Substance Abuse Research, Children's Hospital Boston, Boston, Mass After completing this article, readers should be able to: 1. Discuss current trends in adolescent substance use and the specific substances used most commonly among 8th, 10th, and 12th graders. 2. Identify risk and protective factors, including genetic and environmental correlates, for the initiation of substance use in adolescents. 3. Discuss the most common concomitant mental health disorders and how they can affect the course of diagnosis and treatment for substance abuse. 4. Delineate the variety of treatment options available. 5. Describe the role of the pediatrician in educating patients and families on substance abuse prevention; performing screening and initial assessments; and providing support, brief counseling, or referrals for in-depth treatment. Adolescence is a time of physical, emotional, and psychological maturation as well as a period of searching for independence and experimentation. One area of experimentation associated with adolescence is substance use. (1) Although many adolescents experiment with drugs and alcohol from time to time without enduring problems, those who develop the disorders of substance abuse and dependence make substance use a major public health concern. The Monitoring the Future Study (MTFS) is a nationwide survey measuring smoking, drinking, and illicit drug use among nearly 50,000 8th, 10th, and 12th graders in more than 400 secondary schools in the United States each year. (2)(3) According to the 2006 overview of findings from the MTFS, approximately one fifth (21%) of today's 8th graders, more than one third (36%) of 10th graders, and nearly half (48%) of all 12th graders reported using an illicit drug at least once during their lifetimes. Despite a minimum legal age requirement to purchase alcohol, 6% of 8th graders, 19% of the 10th graders, and 30% of the 12th graders self-reported drunkenness during the month prior to being interviewed. (2)(3) Among the problems experienced by adolescents who use alcohol and drugs are …

Decision Making in the Transtheoretical Model of Behavior Change

Decision making is an integral part of the transtheoretical model of behavior change. Stage of change represents a temporal dimension for behavior change and has been the key dimension for integrating principles and processes of change from across leading theories of psychotherapy and behavior change. The decision-making variables representing the pros and cons of changing have been found to have systematic relationships across the stages of change for 50 health-related behaviors. Implications of these patterns of relationships are discussed in the context of helping patients make more effective decisions to decrease health risk behaviors and increase health-enhancing behaviors.

MOVING BEYOND THE TRANSTHEORETICAL MODEL

MOVING BEYOND THE TRANSTHEORETICAL MODEL

The pros and cons of change in individuals with eating disorders: A broader perspective

The goals of the current study were to develop a questionnaire measuring the pros and cons of eating disorder symptoms and to explore the themes endorsed by different eating disorder groups. Participants recruited from an eating disorder volunteer register and an outpatient clinic completed the Pros and Cons of Eating Disorders scale (P-CED). Principal components analyses (PCA) were performed to validate the factorial structure of the original items and to explore the factorial structure of the new items. Planned comparisons were used to compare P-CED scores between diagnostic groups. PCA indicated a 10-factor solution for the original Pros and Cons of Anorexia Nervosa scale (P-CAN) items and a 4-factor solution for the new items. Participants with anorexia nervosa (AN) scored significantly higher than participants with bulimia nervosa (BN) on five of the P-CED subscales but there were no significant differences between the two AN subtypes. The P-CED is a useful tool for identifying the positive and negative aspects of eating disorders that can be targeted in treatment or used as an outcome measure in research.

The transtheoretical model of health behavior change.

The transtheoretical model posits that health behavior change involves progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Ten processes of change have been identified for producing progress along with decisional balance, self-efficacy, and temptations. Basic research has generated a rule of thumb for at-risk populations: 40% in precontemplation, 40% in contemplation, and 20% in preparation. Across 12 health behaviors, consistent patterns have been found between the pros and cons of changing and the stages of change. Applied research has demonstrated dramatic improvements in recruitment, retention, and progress using stage-matched interventions and proactive recruitment procedures. The most promising outcomes to data have been found with computer-based individualized and interactive interventions. The most promising enhancement to the computer-based programs are personalized counselors. One of the most striking results to date for stage-matched programs is the similarity between participants reactively recruited who reached us for help and those proactively recruited who we reached out to help. If results with stage-matched interventions continue to be replicated, health promotion programs will be able to produce unprecedented impacts on entire at-risk populations.

Characteristics of Individuals on The Precontemplation. Contemplation and Preparation Stages of Change

LEARNING OUTCOME: To compare individuals self-staged in the precontemplation (PC), contemplation (C), and preparation (P) stages of change to individuals who staged themselves into action and maintenance but did not meet the behavioral criterion for assignment to these post-action stages of change.This survey was administered to a proactively recruited random sample of 4S1 adults (age=41±13.8 years) living in Massachusetts. Participants completed a phone interview that included a series of algorithms and scales designed to measure Transtheoretical Model constructs, and a mailed self-administered NCI/Block Food Frequency Questionnaire. Subjects were predominately female (62%), married (58%) and employed outside the home (63%). Based on their responses to the staging algorithms, subjects were divided into two groups: those who were in the PC, C and P stages of change based on intentions to avoid high fat foods (I, n=223), and those who believed they were avoiding high fat foods but did not meet the behavioral criterion of less than 30% energy as fat (R, n=91). Subjects in the R group were reassigned to PC, C or P based on intention to reduce dietary fat below their current intake. Mean percent energy from fat was lower among those in the R group (33.7%±9.0)) than those in the I group (36.6%±5.1), t(281)=3.6, p<.001. A 2×3 multivariate analysis of variance was performed on four dependent variables (DVs): percent energy as fat, temptation to eat high fat foods, and the pros and cons of adopting lower fat eating habits. Results indicated that the DVs were significantly affected by both group (I or R) F(4,371) = 4.11, p< 005, and stage of change (PC, C or P), F(4,386) = 6.41, p<.005. Post hoc analysis (Bonferroni adjustment) indicated the cons of change (barriers) were lower among those who had been reassigned to PC than to those who were initially staged in PC, t(213)=3.12, p<.005. Both the cons of change and temptation were lower among those reassigned to P than among those initially staged in P (cons: t(81) =2.94, p<005: temptation: t(80)=4.65, p<-005). Analysis of variance indicated that the pros of change were higher among those in P and C than among those in PC. The cons were more important to those in C than to those in PC, and temptation was higher among those in C and P than among those in PC. This research reinforces the need for stage specific interventions, and emphasizes the need for individual tailoring within stage of change.

Contraceptive and Condom Use Adoption and Maintenance: A Stage Paradigm Approach

The Transtheoretical Model of Behavior Change was examined for its applicability to contraceptive and condom use adoption and maintenance using N = 248 heterosexually active college-age men and women. The model posits that individuals do not go directly from old behaviors to new behaviors to new behaviors, but progress through a sequence of stages: precontemplation, contemplation, preparation, action, and maintenance. The stages of change offer a temporal dimension that provides information regarding when a particular shift in attitudes, intentions, and behavior may occur. The model also postulates a set of or outcome variables--the pros and cons of change and self-efficacy. The results demonstrated that individuals were furthest along in the stages of change for general contraceptive use, followed closely by condom use with other (e.g., casual) partners, and then condom use with main partners. Although no sex differences were found for the stages for the three separate contraceptive behaviors, males and females differed on the pros and cons and levels of self-efficacy when engaging in intercourse with the two types of partners. MANOVA/ANOVA results indicated that the relationship between stages and other constructs follows predicted patterns suggesting that the transtheoretical model may provide a useful framework or paradigm for understanding contraceptive and condom use behavior.

In Search of a Total Value Assessment Framework: SAFR Symposium Overview and Synthesis

The Social Assessment of Fisheries Resources (SAFR) Symposium explored potentials for more fully using the problem-solving abilities of social sciences in fishery management. The SAFR papers examine the theory, methods, and applications of economics, sociology, anthropology, political science, and philosophy in relation to the kinds of evaluations faced by fishery managers, particularly in North Americaˈs Great Lakes region. In this symposium overview, we consider whether a “total value framework” could be developed to assess all pros and cons of changes in fishery resources. We reject the notion of a perfect, uniform, quantitative total value assessment method, recognizing that existing assessment practices underrepresent some value elements and overrepresent others. Total value concepts must consider both basic human values (“held” values) and monetary or equivalent values, such as those in benefit–cost analysis (“assigned” values). Out total value framework illustrates the difficulty of reconciling these disparate types of human values in ways that lend practical guidance for evaluating fishery management choices. We survey the SAFR papers within this total value framework, considering the potential contributions and shortcomings of each discipline in evaluating human value changes.