Contemplation Stage Research Articles

A medical peer-delivered intervention comprising brief motivational interviewing via instant-messaging interaction to reduce drug misuse among youth in Hong Kong: A protocol for a randomised controlled trial

AimsYouth are frequently exposed to drugs, and most youth who misuse drugs are reluctant to seek help from services due to the worry of others being judgmental, lacking expertise, exposing their personal information, or informing their parents. Considering these concerns, we propose to evaluate the effectiveness of a medical peer-delivered intervention comprising brief motivational interviewing via instant-messaging interaction in reducing drug misuse among youth in Hong Kong.MethodsA two-group single-blind, randomised controlled trial will be conducted. Multiple approaches, including online and face-to-face methods, will be used to recruit the participants. The participants, aged 25 years or younger and reporting any drugs that they have taken within the past 30 days, will be recruited and randomised to receive either brief motivational interviewing via interactive instant-messaging (the intervention) or general health text-messages (comparator). The primary outcome will be the change in the participants’ reductions in self-reported drug consumption at 12 months compared to that at baseline. The secondary outcomes will be the changes in the drug-abusing participants’ reductions in self-reported drug consumption at 6 months, the changes in the drug-quitting participants’ 6- and 12-month contemplation stages and relapse risk compared to that at baseline, 30 days’ self-reported drug abstinence at 6 and 12 months, and the treatment needs and motivation at 6 and 12 months compared to that at baseline. The effectiveness of the proposed intervention will be examined with adjusted regression models, with adjustment for baseline characteristics and the use of an intention-to‐treat approach.DiscussionThis proposed study will be the first randomised controlled trial to assess the effectiveness of a medical peer-delivered interactive intervention to reduce drug misuse among youth in Hong Kong. The proposed intervention has the potential to increase the help-seeking behaviour and intention to quit among youth who misuse drugs. As a result, more youth misusing drugs may be helped to abstain from drugs. This proposed study will inform decisions on whether it is worthwhile to invest resources in large-scale implementation of such an intervention.

Impact of telephone support programme using telemonitoring on stage of change towards healthy eating and active exercise in people with prediabetes

Introduction This study evaluated the impact of a telephone support programme with telemonitoring on changes in healthy eating and active exercise in adults with prediabetes using the stage of change framework. Methods We performed a post hoc analysis using data from the Japan Diabetes Outcome Trial-1. A total of 2607 participants aged 20–65 years with impaired fasting glucose were recruited from the workplace/community in Japan and randomized to a one year telephone support programme intervention arm (n = 1240) or self-directed control arm (n = 1367). Participants in both arms received monthly data feedback from a weight scale and pedometer. The main outcome measure was the stages of change toward healthy eating and active exercise. The secondary outcome was fasting plasma glucose (FPG). Results After the one year intervention, the adjusted odds ratio of progressing to the action/maintenance stage in the intervention vs. control arm for healthy eating was 1.31 (95% confidence interval (CI) 1.21–1.43; p < 0.001), but that for active exercise was 1.07 (95% CI 0.99–1.15; p = 0.062). The intervention decreased FPG levels in participants in the contemplation stage, but not in the precontemplation, preparation and action/maintenance stages. Discussion These findings suggest that the telephone support programme by healthcare providers advanced the stage of changes toward healthy eating in people with prediabetes. In particular, it decreased FPG levels in the contemplation stage.

The PrEP Cascade in a National Cohort of Adolescent Men Who Have Sex With Men.

Pre-exposure prophylaxis (PrEP) has been an available biomedical intervention for at-risk adolescents for over 2 years; however, progression from awareness to uptake and adherence has been slow. In response, we map adolescent men who have sex with men (AMSM) onto the PrEP Motivation Cascade to identify stages for intervention. We analyzed PrEP-related attitudinal and behavioral data from a US national cohort of 1398 AMSM. A majority of the sample (53.9%) were identified as appropriate PrEP candidates. Of those identified as appropriate candidates, 51.8% were precontemplative (stage 1; unwilling to take or believing they were inappropriate candidates for PrEP), and 48.2% reached contemplation (stage 2; willing and self-identified as appropriate candidates). Only 16.3% of candidates reached preparation (stage 3; seeing PrEP as accessible and planning to initiate PrEP), and 3.1% reached PrEP action (stage 4; prescribed PrEP). Although few of the AMSM identified as appropriate candidates were on PrEP, most users (87%) reported high adherence to 4+ doses per week (stage 5; PrEP maintenance). Factors associated with reaching later stages were being older, being out to parents, and engaging in previous HIV/sexually transmitted infection testing. AMSM PrEP use falls short of recommended levels. PrEP campaigns are needed to raise awareness by targeting key AMSM subgroups that underestimate the appropriateness of use. Equally important, parents and health providers of AMSM should serve educational roles to help facilitate potential PrEP uptake, by motivating adolescents and giving them the skills needed to request, fill, and adhere to a prescription.

Exercise Behavior and Self-Efficacy of Medical Students Based on Stages of Change Model

Introduction: Despite the benefits of exercisemany people in different countries specially students, have not enough physical activity. The aim of this research is to study exercise behavior of medical students in Rafsanjan University of Medical Sciences based on stages of change model and assess itsrelationship with students’ self-efficacy.Method: All of the 309 students of Rafsanjan University of Medical Sciences participated in this cross-sectional study. The data collection methodwas a questionnaire which consistedof four parts: demographic characteristics, the pattern of weekly physical activity, the level of exercise behavior which was based on stages of change model and finally the questions which assess exercises self-efficacy. Results: Atotalof 309students(46.6% male and 53.4% female) participated in this study. The mean (SD) of their age was 21.57 (2.20). Based on the stages of change model 117 (37.9%) students were on the pre-contemplation stage. 78 (25.2%), 45 (14.6%), 27 (8.7%) and 42 (13.6%) students were on the contemplation, readiness, action and maintenance stage, respectively. The results showed that there was a significant positive correlation between students’ exercise self-efficacyand their stages of change (p< 0.001).Conclusion: Based on the results of this study, exercise self-efficacy had an important role in students’ exercise behavior. Therefore, it seems to be important for related institutions such as Physical Education Organization tofocus a part of their activities on improving thelevel of exercise self-efficacy in students. Declaration of Interest: None

Smoking cessation in head and neck cancer patients: Factors influencing successes and failures

This study investigated the smoking behaviours and cessation rates of head and neck cancer (HNC) patients, and their barriers and facilitators to cessation. The study used a mixed methods, sequential explanatory design. The quantitative data were collected at baseline (around time of cancer diagnosis) via a survey prior to commencement of treatment. Participants identified as current smokers at baseline were then followed up to determine their smoking status after treatment and asked to participate in one-on-one, semi-structured interviews. Sixty-four participants with HNC were recruited, with 29 classified as current smokers. The 7-day point prevalence cessation rate for current smokers was 72% at 1-month follow-up, and 67% at 3months, while continuous smoking cessation was 54% at 1month, and 42% at 3months. Participants who continued smoking were found to consume more alcohol (P=0.032), be in a lower stage of change (pre-contemplation or contemplation stages of the transtheoretical model) at baseline (P=0.012) and be less confident in being able to cease smoking (P=0.004). Qualitative analysis revealed 5 key themes associated with smoking cessation: the teachable moment of a cancer diagnosis and treatment, willpower and cessation aids, psychosocial environment, relationship with alcohol and marijuana, and health knowledge and beliefs surrounding smoking and cancer. This study demonstrates that the majority of HNC patients achieve smoking cessation, but relapses are common. Cessation programmes should be developed that are comprehensive, sustained and address factors such as alcohol, marijuana and depression.

Using Health Information Technology to Engage African American Women on Nutrition and Supplement Use During the Preconception Period

ImportanceHealthy nutrition and appropriate supplementation during preconception have important implications for the health of the mother and newborn. The best way to deliver preconception care to address health risks related to nutrition is unknown.MethodsWe conducted a secondary analysis of data from a randomized controlled trial designed to study the impact of conversational agent technology in 13 domains of preconception care among 528 non-pregnant African American and Black women. This analysis is restricted to those 480 women who reported at least one of the ten risks related to nutrition and dietary supplement use.InterventionsAn online conversational agent, called “Gabby”, assesses health risks and delivers 12 months of tailored dialogue for over 100 preconception health risks, including ten nutrition and supplement risks, using behavioral change techniques like shared decision making and motivational interviewing. The control group received a letter listing their preconception risks and encouraging them to talk to a health care provider.ResultsAfter 6 months, women using Gabby (a) reported progressing forward on the stage of change scale for, on average, 52.9% (SD, 35.1%) of nutrition and supplement risks compared to 42.9% (SD, 35.4) in the control group (IRR 1.22, 95% CI 1.03–1.45, P = 0.019); and (b) reported achieving the action and maintenance stage of change for, on average, 52.8% (SD 37.1) of the nutrition and supplement risks compared to 42.8% (SD, 37.9) in the control group (IRR 1.26, 96% CI 1.08–1.48, P = 0.004). For subjects beginning the study at the contemplation stage of change, intervention subjects reported progressing forward on the stage of change scale for 75.0% (SD, 36.3%) of their health risks compared to 52.1% (SD, 47.1%) in the control group (P = 0.006).ConclusionThe scalability of Gabby has the potential to improve women’s nutritional health as an adjunct to clinical care or at the population health level. Further studies are needed to determine if improving nutrition and supplement risks can impact clinical outcomes including optimization of weight.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT01827215.

The effect of theory - Based educational intervention on consumption of smokeless tobacco products by merchants' guilds.

BACKGROUND:Smokeless tobacco (SLT) products are highly addictive and contain at least 28 carcinogenic chemicals. The purpose of this study was to determine the effect of theory-based on the Transtheoretical Model of Behavior Change on consumption of SLT products by Merchants’ Guilds in 2018.MATERIALS AND METHODS:The present quasi-experimental research was conducted over one intervention group. The research population consisted of all consumers of the SLT products among the merchants’ guilds in Chabahar City, Iran in 2018. Data were gathered from 320 individuals by simple random sampling using a valid and reliable researcher-made questionnaire. The intervention program was designed based on the Transtheoretical Model of Behavior Change cognitive processes and lasted 6 months. After the intervention, the same questionnaires were administered among the participants. The data were analyzed by SPSS version 20 using the descriptive and analytical tests.RESULTS:In the preintervention phase, the participants’ mean scores of the cognitive processes at the precontemplation, contemplation, and preparation stages were 29.16 ± 4.63, 25.07 ± 3.84, and 12.12 ± 1.63, respectively. At the postintervention phase, mean scores of the precontemplation, contemplation, and preparation stages reached to 40.5 ± 5.96, 38.8 ± 5.03, and 35.5 ± 4.23, respectively. Furthermore, the participants’ mean sores at the action and maintenance stages were 36.4 ± 4.57 and 43.3 ± 3.29, respectively. According to the ANOVA, a significant relationship was found between cognitive processes at the preintervention phase and stages of change (P < 0.001).CONCLUSIONS:Individuals can improve from the precontemplation, contemplation, and preparation phases to the action and maintenance stages by attending based on Transtheoretical Model of Behavior Change educational interventions. It is suggested that the structure of this model be used to reduce high-risk behaviors in other occupations.

Cigarette Smoking Behaviors and Beliefs in Persons Living With HIV in Nairobi, Kenya.

IntroductionPersons living with HIV (PLWH) use tobacco at higher rates than the general population in both high-income countries and low- and middle-income countries. Tobacco use rates are increasing in sub-Saharan Africa, the home to most of the world’s PLWH. As the reach of antiretroviral therapy (ART) expands and HIV-related morbidity and mortality wanes, tobacco use is emerging as a leading cause of disease and death in PLWH. A better understanding of tobacco use behaviors in various settings will be crucial to designing optimal tobacco control strategies.MethodsIn late 2019, we enrolled 50 PLWH cigarette smokers from 6 clinical sites in Nairobi, Kenya (4 HIV care clinics and 2 methadone maintenance programs) for one-on-one interviews focusing on their behaviors and beliefs related to tobacco use.ResultsFifty PLWH smokers completed the interviews. The mean age was 38.5 ± 9.7 years (range 20-57 years) and 68% were male. All were currently receiving ART. They smoked a mean of 14.9 ± 12.4 cigarettes per day, and 82% reported smoking every day. Only 6% reported dual use of smokeless tobacco products. Nicotine dependence was moderate or high in 74%. More than a third (36%) reported a prior history of tuberculosis. In our sample, use of other substances was common, especially alcohol, marijuana, and methadone. On the motivation to quit scale, 90% were at least in the contemplation stage, but only 2% had ever received behavioral cessation counseling, and only 8% had ever used pharmacotherapy (exclusively nicotine replacement therapy). Participants reported significant concern about developing smoking-related illness, exposing others to secondary smoke, and the financial burden associated with their tobacco use. Measures of intrinsic and extrinsic motivation to quit, smoker and abstainer self-concept, and social support yielded encouraging results regarding the possibility of successful quitting.ConclusionsTobacco use is an important health concern in PLWH in Kenya. A more thorough understanding of their tobacco use behaviors and beliefs will provide critical information for providers, public health officials, and policy makers as they redouble their efforts to confront this urgent health challenge.

A case of pregabalin addiction.

Pregabalin, a gamma-aminobutyric acid analog, is a new-generation anticonvulsant that acts by reducing the release of glutamate, noradrenaline, and substance P. Apart from use as concomitant therapy in partial epilepsy, it is used in the treatment of treat neuropathic pain, fibromyalgia, and generalized anxiety disorder. Experimental studies have claimed its usefulness in the treatment of benzodiazepine dependence and withdrawal, as well as preventing relapse in alcohol-dependence patients.[12] Pregabalin use in primary health care has increased recently. In therapeutic dosage, chances of addiction are unlikely. However, there are few reports of addictive potential of the drug when prescribed in higher amount.[3] A case of pregabalin addiction is presented because of its rarity in India. A 32-year-old married male, an operation theater assistant, reported with the complaints of regular use of tablet pregabalin for the past 7 years. Initially, the patient was prescribed tablet gabapen 300 mg bd for chronic pain following traumatic mandibular subluxation. After taking the medication for 3 months, he perceived improvement in his pain. He also felt energetic. When he stopped taking tablet gabapen, he experienced fatiguability and irritability. Since tablet gabapen was costly and he had easy access to tablet pregabalin, he started consuming pregabalin. However, he was not getting the same effect, so he kept increasing the dosage and eventually was consuming 20 tablet/day. At this dose, he used to feel energetic, elated, had increased work performance, and was appreciated by his seniors. His appetite increased significantly. Over the course of 7 years, he experienced diminishing effect, so he gradually increased the dosage to 40 tablet/day. Finally, he was caught stealing drugs and was removed from the job. To satisfy his craving, he started taking loans and sold household articles, and consequently, his family abandoned him. He then tried stopping tablet pregabalin for a few days, but he experienced low mood, irritability with decreased sleep, and appetite, so he restarted taking the tablets. His friend eventually brought him to the psychiatric center. Past and family history was not significant. No history of other substance use was reported. His physical examination and routine investigations were within normal limits. Electroencephalogram showed right frontocentral abnormality. On mental status examination, he was in contemplation stage of motivation. He was admitted and was started on tablet oxcarbazepine 150 mg bd, tablet clonazepam 0.25 mg tds, and tablet tryptomer 10 mg along with psychotherapy. Gradually, his craving reduced and he has maintained abstinence for 3 months after discharge. A systematic review of 106 studies on PubMed/Scopus did not find credible evidence of a strong addictive power of gabapentinoids, due to their limited rewarding properties, few relapses, and the very few cases with gabapentinoid-related behavioral dependence symptoms in patients without a history of substance abuse/dependence. Further, there were no reports of people seeking treatment for abuse of gabapentinoids.[4] Our patient was strongly addicted, felt euphoric and energetic due to the drug, gave history of relapse, and came for treatment. It is assumed that gabapentinoid pharmacodynamics possibly include brain's drug-reward pathways.[5] Physicians prescribing gabapentins should carefully evaluate any history of substance misuse before starting the drug. Furthermore, they should be able to promptly identify signs of pregabalin/gabapentin misuse, while providing assistance in tapering off the medication.[6] The tendency to downplay the addiction potential of gabapentinoids should cease forthwith. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the legal guardian has given his consent for images and other clinical information to be reported in the journal. The guardian understands that names and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Future Care Plan at the Contemplation Stage Among Older Adults

Previous studies have shown that making future care planning often involves several steps. This is consistent with the transtheoretical model of behavior change which identified stages in which behavior changes over time and progresses through a series of six stages (Prochaska & Norcross, 2001). Although most studies on future care planning among older adults have examined the progression from the pre-contemplation stage to an action stage, little is known about the unique characteristics of older adults at the contemplation stage. Our sample included 409 randomly selected older adults in Cleveland, Ohio who were in the first wave of a longitudinal study of successful aging (µage = 78.8, SD=5.74). We used multivariate logistic regression to predict older adults who are more likely to have thought of their future care plans (contemplation stage). Results indicate several individual and relationship factors such as marital status, engaging in health behaviors (not smoking), being young old, and having personal transportation (OR=.42, .63, 2.81, and 1.73) account for contemplating future care. These findings underscore that several individual resources, as well as relationship status, are associated with contemplation stage of future care planning. The results reinforce the idea that future care planning is a stage-based behavior that people engage in, rather than a stand-alone activity.

Seven in every ten khat chewers in Gondar City had an intention to stop khat chewing: cross-sectional study using\xa0Transtheoretical Model

BackgroundKhat chewing practice is rapidly expanding worldwide and currently, an estimated over 10 million people chew khat daily. The transtheoretical model explains how behavior change occurs across the stages of change. So, this study aimed at assessing the intention to stop khat chewing and associated factors among khat chewers in Gondar City, northwest Ethiopia.MethodsCommunity-based cross-sectional study was conducted from March to April 2019 in Gondar City, northwest Ethiopia. Six hundred five khat chewers participated in the study from six randomly selected kebeles. The data were collected using structured and interviewer-administered questionnaire. Bivariate and multiple logistic regression models were fitted. Adjusted Odds ratio (AOR) with 95% confidence interval (CI) and p-values less than 0.05 were used to declare a significant association.ResultsOf the study participants, 69.3% (95% CI: 65.8–72.9) had the intention to stop khat chewing within 6 months or before. The majority of the participants (55.4%) were at the contemplation stage. Higher self-reevaluation [AOR = 2.8, (95%CI: 1.6–5.0)], environmental reevaluation [AOR = 1.9, (95%CI: 1.1–3.3)] and social liberation [AOR = 1.8, (95% CI: 1.0–3.1)] were associated with intention to quit khat chewing. In addition, using additional substances daily, khat dependency, and early age initiation of khat chewing were associated with lower intention to quit khat chewing.ConclusionThe majority of the khat chewers had the intention to quit khat chewing. Increased self-reevaluation, environmental reevaluation, and social liberation process of changes were associated with enhanced intention of quitting khat chewing. Thus, stage-based interventions should be done to inspire khat chewers to realize their motivation of stopping khat chewing.

STAGES OF SMOKING CESSATION AMONG ADULT CURRENT SMOKERS IN MALAYSIA: FINDINGS FROM THE NATIONAL E-CIGARETTE SURVEY 2016

Identification of the stages of smoking cessation among smokers is essential to improve the rate of smoking cessation. The aims of this study were to determine the prevalence and factors associated with stages of smoking cessation across the demographic distribution of adult smokers in Malaysia. Data were derived from a population-based study among Malaysian adults aged 18 years and above. Face-to-face interviews were carried out by trained staff using a validated questionnaire to obtain data related to smoking from 4,288 selected respondents. Of 4,288, 438 respondents are current smokers. Multivariable logistic regression analysis was used to determine factors associated with stage of smoking cessation. Approximately 60% (n=269/438) of the current smokers were in the pre-contemplation stage and 40% (n=169/438) were in the contemplation and preparation stages of smoking cessation. The proportion of pre-contemplators was higher among smokers with higher levels of nicotine addiction (71.3%), lower education attainment (71.4%), and those who were single/widowed/divorced (66.9%). Multivariable analysis showed that males, and those who reported low to high level of nicotine addiction were more likely to be in the pre-contemplation stage whilst those in the older age groups were more likely to be in the advanced stage of smoking cessation. The study revealed that the majority of current smokers in Malaysia had no intention to quit smoking within 6 months. Specific interventions targeting males, young adults and smokers with low to high nicotine addiction should be introduced to ensure the smokers proceed to the advanced stage of smoking cessation.

Examination of factors contributing to help-seeking behavior in accessing psychosocial support services among Japanese cancer patients: An application of the segmentation approach.

Various psychosocial support services for cancer patients are available in Japan; however, their utilization rate is low. The present study aimed to examine factors contributing to help-seeking behavior in the use of psychosocial support services among cancer outpatients at three stages: Precontemplation (without adjustment disorder or major depression), Precontemplation (with adjustment disorder or major depression), and Contemplation. We conducted a web-based questionnaire survey at two points with a panel of cancer outpatients. We collected data on demographic information, physical status, the use of and intention to use psychosocial support services, psychological distress, attitude toward using psychosocial support services for cancer patients, and social support. In total, 395 cancer patients were analyzed. In the Precontemplation (without adjustment disorder or major depression) stage, resistance to help-seeking (OR = 0.726, P = .011) and future prospects of the Brief Cancer-Related Worry Inventory (OR = 1.012, P = .019) were significant. In the Precontemplation (with adjustment disorder or major depression) stage, only recommendation by medical staff or family (OR = 0.000, P = .026) had a significant effect. In the Contemplation stage, only social and interpersonal problems (OR = 0.942, P = .080) showed a significant (negative) trend. This study showed that contributing factors differed by stage. To encourage the use of psychosocial support services, it is desirable to recommend the use and to develop interventions for promoting, with responding to patients' conditions and intentions rather than responding to everyone in the same way.

Effectiveness of nutrition education in improving fruit and vegetable consumption among selected college students in urban Puducherry, South India. A pre-post intervention study.

World Health Organization (WHO) suggests intake of five servings (400g) of fruits and vegetables (F&V) per day to ensure an adequate dietary fibre and to reduce the risk of non-communicable diseases. Risk factor survey of Non-Communicable Diseases (2007-08), reports that only 1% population in Tamil Nadu, South India consumed more than five servings a day. So we aimed to assess the effectiveness of nutrition education in improving the daily intake of fruit and vegetable servings and stage of behaviour change among college students. A pre-post intervention study was conducted among undergraduate students from two selected women's colleges in urban Puducherry, South India during September-October 2019. The two English departments were randomly allocated into intervention group (IG), control group (CG) and 75 students in each group were chosen by systematic random sampling. IG received 30min of nutrition education programme; which includes importance and minimum daily intake of fruits & vegetables, local availability, cost and awareness about myths and misconceptions. CG received pamphlets regarding healthy dietary intake. Knowledge regarding portion sizes, average daily servings of fruit & vegetable intake and stage of behaviour change were assessed at baseline and after one month of intervention. There was a significant increase in knowledge regarding portion sizes (28- 64%) after intervention in IG (p<0.001) compared to CG (24- 40%). The knowledge regarding the required number of servings of fruits (27-56%) and vegetables (15-58%) also increased significantly (p<0.001) in the IG. Intake of fruits, vegetables and juices in the last 24h were significantly increased in IG compared to CG (p<0.001). There was a significant increase (p=0.002) in contemplation and preparation stage (13-34%) in IG after intervention. A well designed nutrition education programme is an effective tool in promoting healthy eating habits among adolescents. It enabled a significant increase in knowledge regarding portion sizes of F&V and daily intake of fruits and vegetables.

Stages of Behaviour Change Related to Physical Activity and the Associated Barriers among College-Going Adolescents in Puducherry- Cross Sectional Study

Background: One in every ten deaths globally is reported by physical inactivity related risks. Adolescents constitute 18% of the total population, due to physical inactivity they are more at risk of noncommunicable diseases. This study aims to find the level, stages of behaviour changes, associated barriers related to physical activity among adolescents. Methods: Quantitative, cross-sectional study was done at Tagore College based on Multi-stage cluster sampling. 920 adolescents in the age group of 18-19 years were included in the study. Global Physical Activity Questionnaire (GPAQ) and Trans theoretic models were used to assess the level of physical activity and stages of behaviour change related to physical activity. In addition, barriers to participating in physical activity were also elicited. Result: About one-fifth of the subjects (20.4%) were physically inactive. It was found that they are in pre-contemplation and contemplation stages (14.7%) of behaviour change related to physical activity. Compared to females, males have a higher chance to do physical activity and was statistically significant (p<0.001). The major barriers to physical activity were personal barriers like lack of time and having multiple tasks. Healthy practices in a family also found to have a significant association with increased physical activity. (p<0.001). Conclusion: Many barriers were reported that prevent adolescents from taking up sufficient physical activity. Therefore, attempt should be taken to emphasize the importance of physical activity among family members, individuals, and the peer friends at the community level. Primordial prevention in the vital emergence of risk factors for NCDs like sufficient physical activity is vital for reducing burden of chronic diseases in our country. How to cite this article: Angayarkanni A, Barathi A, Ramesh R, Lakshminarayanan S. Stages of Behaviour Change Related to Physical Activity and the Associated Barriers among College-Going Adolescents in Puducherry- Cross Sectional Study. Ind J Youth Adol Health 2020; 7(1): 15-22. DOI: https://doi.org/10.24321/2349.2880.202003

Attitudes towards change mediate the effect of dissociation on psychopathological outcome in the treatment of eating disorders.

The study aimed to examine whether dissociation and attitudes towards change were associated with the psychopathology in patients with eating disorders (EDs) at 1-year follow-up. The study included 110 females with anorexia nervosa and bulimia nervosa (48 and 62 respectively). At the beginning of the study and 1 year later, they were assessed by means of the following questionnaires: Dissociative Experiences Scale, Attitudes Towards Change (ACTA), State-Trait Anxiety Inventory, Rosenberg Self-Esteem Scale, Beck Depression Inventory, Eating Attitude Test, Bulimic Investigatory Test Edinburgh and Body Shape Questionnaire (BSQ). No statistically significant differences were found between both diagnostic groups regarding dissociation scores. The ACTA at baseline, specifically for patients in the contemplation stage, mediate the effect of dissociation on the psychopathological outcome. These findings suggest that dissociation might be a transdiagnostic feature related to the EDs outcome. The psychotherapeutic framework must take it into account, particularly in patients in the contemplation stage.

Smoking cessation advice from healthcare professionals helps those in the contemplation and preparation stage: An application with transtheoretical model underpinning in a community-based program.

INTRODUCTIONThe efficacy of smoking cessation intervention has been proven with randomized controlled trials. Our study aims to elucidate the effects of the delivery method of smoking cessation advice on the process of stage of changes with transtheorectical model underpinning in a community setting.METHODSA total of 436 subjects were recruited in a quasi-experimental untreated control design study, with 46 receiving advice from healthcare professionals (HCP group) and 390 in the control group, in 2003, Nantou, Taiwan. A discrete time Markov model was used to quantify the multi-state process of smoking cessation in light of the transtheorectical model. Multiple polytomous logistic regression models were simultaneously applied to different transitions.RESULTSThe estimated forward transition probabilities were higher in the HCP group compared to their counterparts in the control group. On the other hand, the backward transition probabilities were smaller in the HCP group. After adjusting for confounding factors, HCP had a 4.3-fold (95% CI: 2.21–8.46) odds ratio of moving forward from the contemplation stage, and 2.4-fold odds ratio (95% CI: 1.03–4.42) from the preparation stage. Elderly people were more reluctant to change from precontemplation (AOR=0.50; 95% CI: 0.34–0.74) and contemplation (AOR=0.58; 95% CI: 0.44–0.84), but once in the preparation stage, they were more likely to take action (AOR=1.28; 95% CI: 1.01–1.83). For those in the preparation stage, longer smoking years had a negative effect on taking action (AOR=0.74; 95% CI: 0.52–0.99), but cessation advice from others enhanced the likelihood to take action (AOR=1.36; 95% CI: 1.01–1.99).CONCLUSIONSThe direct advice on smoking cessation from healthcare professionals enforced the net forward transition towards smoking cessation, especially the transition from contemplation and preparation. The proposed Markov regression model assessed the net effect of different intervention approaches allowing for the simultaneous consideration of multiple transitions and the effects of other confounders.

Barriers To The Practice Of Physical Activity Among Adults According To Socioeconomic Status In Chile

PURPOSE: to identify personal and environmental barriers for physical activity practice and the stage of change in residents of communes with three different socioeconomic status (SES). METHODS: Cross-sectional analytical study. Three communes of the city of Santiago de Chile with high, medium and low SES were selected. The stage of behavior change was determined with the “Physical Activity Stages of Change Questionnaire” and the barriers for physical activity practice through the “Barriers to Being Active Quiz”. The precontemplation, contemplation and preparation stages were grouped as inactive state, and the action, maintenance as active state. The barriers were compared between communes and associated with the inactive state with a multivariate regression. RESULTS: 296 participants were surveyed, age = 49 (P25 = 37-P75 = 57) years, 60.1% women. In an inactive state, 48.5% in high SES, 60% in medium SES and 63.1% in low SES. The most prevalent barrier to physical activity according to SES was: lack of time for high SES (74.2%); lack of will for medium SES (62% ) and lack of resources for low SES (59.2%). The lack of skills is the only barrier that presents a significant difference p <0.05 among all communes, 31.8% high SES, 46% medium SES and 19.2% low SES. The lack of skills presented an OR 1.15 (1.02-1.31) p = 0.025 for the inactive state in a multivariate analysis. CONCLUSIONS: the barriers to practice physical activity differ according to SES and can be a guide for personal and environmental interventions. Overcoming the lack of skills barrier could increase the active subjects.

Perceptions About Mindfulness and Text Messaging for Smoking Cessation in Vietnam: Results From a Qualitative Study

BackgroundWith 15.6 million smokers, Vietnam is one of the top 10 largest cigarette-consuming countries in the world. Unfortunately, smoking cessation programs are still scarce in Vietnam. Mindfulness-based and text messaging–based interventions have been increasingly used in smoking cessation studies in developed countries, with promising results. Given the exponential growth of mobile phone usage in Vietnam in recent years, mobile health interventions could be a potential strategy to increase smoking cessation in Vietnam. However, substantial cultural adaptations are needed to optimize the effectiveness of these interventions among Vietnamese smokers.ObjectiveThis study aims to involve qualitative research to inform the development of a mindfulness-based text messaging smoking cessation intervention for Vietnamese smokers.MethodsA total of 10 focus groups were conducted with 71 Vietnamese male smokers aged between 18 and 65 years (5-9 participants per focus group). Overall, 5 focus groups were conducted with smokers who had the intention to quit (ie, preparation stage of change in the transtheoretical model), and 5 focus groups were conducted with smokers who did not have the intention to quit (contemplation or precontemplation stage). The focus groups were audio recorded, transcribed verbatim, and analyzed using NVivo 12 software (QSR International).ResultsThe major themes included smoking triggers, barriers and facilitators for quitting, the perceptions of text messaging and mindfulness approaches for smoking cessation, and suggestions for the development of a text messaging–based smoking cessation program. Common smoking triggers included stress, difficulties concentrating, and fatigue. Frequently encountering other people who were smoking was a common barrier to quitting. However, participants indicated that concerns about the harmful effects of smoking on themselves and their wives and children, and encouragement from family members could motivate them to quit. The participants preferred diverse message content, including information about the consequences of smoking, encouragement to quit, and tips to cope with cravings. They suggested that text messages be clear and concise and use familiar language. Most smokers perceived that mindfulness training could be useful for smoking cessation. However, some suggested that videos or in-person training may also be needed to supplement teaching mindfulness through text messages.ConclusionsThis study provides important insights to inform the development of a text messaging–based smoking cessation program that incorporates mindfulness for Vietnamese male smokers. The results could also be useful for informing similar programs in other low- and middle-income countries.

Understanding help-seeking behaviour in relation to psychosocial support services among Japanese cancer patients.

There are various psychosocial support services for cancer patients in Japan; however, their utilization rate is lower than in Western countries. The aim of this study was to investigate the actual status of the utilization of such services and the related factors of their use, using the transtheoretical model. We conducted an Internet survey of cancer outpatients. They were asked for information on their demographics, physical status and the usage of and intention to use psychosocial support services, and to answer the Hospital Anxiety and Depression Scale. Data of 712 participants were analyzed; 111 had made use of psychosocial support services (15.6%). Participants who were younger, female, had breast cancer, experience with hormone therapy and did not have a good performance status (Karnofsky Performance Scale) more often used such services when comparing users/experiencers with non-users/inexperienced. Of the inexperienced, 538 were in the Precontemplation stage (89.5%), 62 were in the Contemplation stage (10.3%) and one was in the Preparation stage (0.2%). Approximately 35% of those in the Precontemplation stage would correspond to adjustment disorders or major depression. We showed the degree of cancer patients who have used the psychosocial support services and its contents and revealed the factors related to the utilization of such services in Japan. Our study supports previous reports that cancer patients with high levels of distress do not necessarily seek support, and thus future studies should also examine other modifiable factors considering the medical settings.