Multi-theory Model Research Articles

Utilizing Multi-Theory Model in Determining Intentions to Smoking Cessation Among Smokers.

Background:Smoking is a risk factor for lung cancers, and a myriad of other acute and chronic ailments. The purpose of this study was to predict initiation and sustenance of smoking cessation among smokers using a fourth-generation behavioral framework, multi-theory model (MTM) of health behavior change.Methods:A convenience sample of smokers from a shopping mall in rural, Appalachian Kentucky county was invited to participate in this cross-sectional study. A 38-item, face and content validated, MTM-based survey instrument was administered to the participants.Results:A total of 148 participants completed the study. The mean age of the participants was 35.53 (SD = 14.52) years. Most were male (58.1%) and Caucasian (95.9%). Participants reported smoking for an average of 16.45 (SD = 13.12) years. Participatory dialogue (β = 0.235, P = .003) and behavioral confidence (β = 0.305, P = .005) were significant predictors of intention for initiation for smoking cessation behavior. Emotional transformation (β = 0.319, P = .001) was a significant predictor of intention for sustenance for smoking cessation behavior.Discussion:Two of the MTM constructs for initiation and one of the MTM constructs for sustenance of change accounted for a moderate amount of variance in initiation and sustenance of smoking cessation behavior among community members in a rural, Kentucky county. MTM has utility for predicting both initiation and sustenance of smoking cessation behavior. Future interventions using MTM constructs should be developed for smoking cessation behavior change.

Promoting physical activity in upper elementary children using multi-theory model (MTM) of health behavior change.

SummaryBackgroundPhysical activity and exercise offer numerous benefits to children and Centers for Disease Control and Prevention guidelines require that school children engage in at least 60 minutes of moderate to vigorous physical activity every day. Unfortunately, up to 30% elementary students do not meet these requirements and 79% elementary schools do not provide students with physical education classes every day. The transition from elementary to secondary school is particularly deleterious for levels of physical activity. Therefore, there is a need to develop educational interventions for upper elementary school children to promote physical activity. A new theory multi-theory model (MTM) of health behavior change can be utilized to develop such interventions.ObjectivesThe purpose of this article was to develop and introduce an instrument based on MTM for physical activity change in upper elementary school children and propose an approach for changing this behavior among sedentary students.MethodsA review of literature in MEDLINE, CINAHL, Google Scholar, and ERIC databases was conducted for physical activity in upper elementary children and multi-theory model of health behavior change to prepare this article.ResultsAn instrument with Flesch-Kincaid Grade level of 5.4 and the Flesch Reading Ease of 68 making it suitable for administration with upper elementary school children was developed. An approach utilizing the constructs of participatory dialogue, behavioral confidence and changes in physical environment to initiate physical activity and reifying the constructs of emotional transformation, practice for change and changes in social environment to sustain physical activity in upper elementary school children is presented.ConclusionsMTM offers potential to augment current educational efforts to promote physical activity in upper elementary school children.

Multi-theory model of behavior change: an appropriate model for creating health behaviors

Multi-theory model of behavior change: an appropriate model for creating health behaviors

Using a Multitheory Model to Predict Initiation and Sustenance of Fruit and Vegetable Consumption Among College Students.

Consuming a diet rich in fruits and vegetables offers numerous health benefits. However, many college students do not consume the recommended amount of fruits and vegetables daily. To predict change in fruit and vegetable consumption behavior among college students who were not eating the recommended amount of fruits and vegetables using the multitheory model (MTM) of behavior change. In this cross-sectional study, a 38-item face-, content-, and construct-valid survey was sent to college students at a large university in the southeastern United States. Students were included in the analysis if they were aged at least 18 years and ate less than 5 cups of fruits and vegetables per day. The survey was broken into sections based on the MTM constructs of initiation of behavior change (participatory dialogue, behavioral confidence, and changes in physical environment) and sustenance of behavior change (emotional transformation, practice for change, and changes in social environment). Stepwise multiple regression was conducted to predict behavior change regarding fruit and vegetable consumption. Of the 5000 potential respondents, 175 completed the survey and were included in the analysis. Behavioral confidence and changes in physical environment were statistically significant predictors of the intention to initiate fruit and vegetable consumption (F2,173=59.700; P<.001) and accounted for 40.2% of the variance. Emotional transformation, practice for change, and changes in social environment were statistically significant predictors for the intention to sustain fruit and vegetable consumption (F3,171=26.374; P<.001) and accounted for 30.4% of the variance. Survey results showed that the MTM is a useful framework for designing behavior change interventions to promote fruit and vegetable consumption among college students.

Predictors of Responsible Drinking or Abstinence Among College Students Who Binge Drink: A Multitheory Model Approach.

Binge drinking is a salient problem on college campuses, with estimates as high as 40% of students engaging in it. Binge drinking is associated with numerous negative consequences among college students, such as suicide attempts, unsafe sex practices, property damage, and driving under the influence. Several behavioral approaches in this regard have had modest impact and only short-term effects, however. To use the multitheory model (MTM) of health behavior change to predict initiation and sustenance of responsible drinking or abstinence among binge-drinking college students in a sample drawn from a large southern public university. This cross-sectional survey study included a sample of college students who binge drank in the past 30 days. A 39-item face- and content-valid instrument was used. In addition, construct validity using confirmatory factor analysis and internal consistency reliability using the Cronbach α were established. Hierarchical regression modeling was used to build models. A total of 289 students participated. The Cronbach α for the scale and all subscales ranged from 0.81 to 0.94 and demonstrated acceptable internal consistency reliability. Construct validity using confirmatory factor analysis yielded 1-factor solutions for each of the subscales. On hierarchical regression modeling, gender (P=.05), race/ethnicity (P=.004), behavioral confidence (P=.029), and changes in physical environment (P=.001) were associated with intended initiation for drinking responsibly/abstinence behavior change. The addition of MTM constructs led to a significant increase in R2 of 0.20 (F3,194=18.1; P<.001). The sustenance constructs yielded a significant increase in R2 of 0.20 (F3,193=19.4; P<.001). This study provides empirical justification for MTM constructs that can be used to inculcate the intention to drink responsibly or abstain among college students who binge drink. This predictive model may prove valuable in the design of interventions aiming to improve responsible drinking behavior in this population.

Abstract 5280: Predicting initiation and sustenance to smoking cessation among smokers using multi-theory model (MTM) approach

Abstract Background and Hypothesis. The purpose of this study was to determine whether the initiation and sustenance of smoking cessation among smokers in the Appalachian region can be predicted using a newly proposed health behavior theory called the multi-theory model (MTM) of health behavior change. MTM may provide an innovative treatment plan for patients trying to quit smoking in order to improve cancer outcomes and decrease disparities in cancer outcomes in the Appalachian region. Smoking rates are 1.8 and 1.6 times greater in women and men, respectively, in Appalachian Kentucky than in the rest of the nation. MTM predicts health behavior change across cultures by proposing that health behavior change occurs in two stages: initiation of the behavior change and sustenance of the behavior change. This model has been validated for several other health behavior changes. The primary research question this study seeks to answer is: to what extent can MTM be used to predict quitting smoking and long-term sustenance of smoking cessation in current smokers? We hypothesized that MTM significantly predicts quitting smoking and long-term sustenance of smoking cessation in smokers. Research Methods. The study utilized a cross sectional design. IRB permission from the university was obtained to conduct the study. Investigators approached mall-goers at the Middlesboro Mall in Middlesboro, KY and asked current tobacco smokers to voluntarily participate in the study. In order to maintain anonymity, no identifiers or signatures were collected from the participants. Exclusion criteria included participants that were illiterate or who had poor vision. The survey instrument was a face and content valid 38 question assessment about the smokers' background and questions pertaining to the constructs of MTM. Data Analyses: Descriptive statistics were computed to summarize the data. In order to assess internal consistency reliability of the scales, Cronbach's alpha were computed. Confirmatory factor analyses were conducted on subscales to establish construct validity. Stepwise multiple regression analyses were performed to determine best possible predictors of initiation and sustenance of smoking cessation among people who were currently smoking. A p-value less than 0.05 was considered significant. Results: Data collection is complete and results are being complied and will be presented at the conference. Conclusion: This study aims to determine to what extent MTM can be utilized to explain quitting smoking and long-term sustenance of smoking cessation in smokers. In the interim, MTM appears to be a useful model for predicting health behavior change, and for designing interventions promoting smoking cessation in smoking patients. Citation Format: Falguni Patel, Richard W. Kim, Ghazal Ghafari, Bernhard Dietz, Vinayak K. Nahar, Manoj Sharma. Predicting initiation and sustenance to smoking cessation among smokers using multi-theory model (MTM) approach [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5280.

Using Social Cognitive Theory to Predict Medication Compliance Behavior in Patients with Depression in Southern United States in 2016 in a Cross-Sectional Study.

Introduction: Depression is a major public health issue. One of the concerns in depression research and practice pertains to non-compliance to prescribed medications. The purpose of the study was to predict compliance with medication use for patients with depression using social cognitive theory (SCT). Based on this study it was envisaged that recommendations for interventions to enhance compliance for medication use could be developed for patients with depression. Methods: The study was conducted using cross sectional design (n=148) in southern United States with a convenience sample of clinic-based depression patients with a 37-item valid and reliable questionnaire. Sample size was calculated to be 148 using G*Power (five predictors with a 0.80 power at the 0.05 alpha level and an estimated effect size of 0.10 with an inflation by 10% for missing data). Social cognitive theory constructs of expectations, self-efficacy and self-efficacy in overcoming barriers, self-control, and environment were reified. Data were analyzed using multiple linear regression and multiple logistic regression analyses. Results: Self-control for taking medication for depression (P=0.04), expectations for taking medication for depression (P=0.025), age (P<0.0001) and race (P=0.04) were significantly related to intent for taking medication for depression (Adjusted R2 = 0.183). In race, Blacks had lower intent to take medication for depression. Conclusion: Social cognitive theory is weakly predictive with low explained variance for taking medication for depression. It needs to be bolstered by newer theories like integrative model or multi-theory model of health behavior change for designing educational interventions aimed at enhancing compliance to medication for depression.

New approach for promoting HPV vaccination in college men based on multi-theory model (MTM) of health behavior change.

New approach for promoting HPV vaccination in college men based on multi-theory model (MTM) of health behavior change.

Social psychological aspects of ACL injury prevention and rehabilitation: An integrated model for behavioral adherence

Managing rehabilitation for ACL injury is dependent on uptake of, and compliance with, medical and safety recommendations. In this paper, we propose a multi-theory model that integrates self-determination theory and the theory of planned behavior to identify the motivational determinants ACL injury prevention and management behaviors and the processes involved.

Future Application of Multitheory Model of Health Behavior Change for Skin Cancer Prevention Behaviors

ABSTRACT Skin cancer is a global health issue and constitutes the most common form of cancer worldwide. Exposure to ultraviolet radiation is a primary skin cancer risk. Engaging in sun protection behavior could mitigate this risk. Several sociobehavioral theories can be used to better explain and predict health behaviors. Unfortunately, application of theories has yielded mixed results with variable predictability. Most importantly, they do not impact long-term changes in behavior. Therefore, there is still a need to develop theoretical models that better explain and predict health behaviors, in particular, sun-safe behaviors. A recently proposed health behavior theory, called the multitheory model of health behavior change, may be the answer. The multitheory model has been shown to be effective in changing attitudes toward other health behaviors such as physical activity, portion size control, and sleep deprivation. It is unique from established health behavior theories because it emphasizes long-term change over short-term behavior modification, which is more likely associated with relapse. It does this by separating factors that lead to short-term change from those that promote long-term behavior adoption. This article presents the application of the principles of multitheory model to skin cancer preventative behaviors.

Applying multi-theory model of health behaviour change to address implicit biases in public health

A person receiving public health services should not receive a lesser standard of service because of his/her race, gender, age, colour, national origin, disability status, occupation or any other extraneous characteristics. However, sometimes our perception based on these hidden linkages (unconscious, irrepressible, or irrational connotations) may influence our judgements resulting in unfairness which are referred as implicit biases. Such biases can result in poorer quality of care. In public health, where the ultimate motive is to ensure social justice, these implicit biases are thus quite deleterious. The purpose of this article was to examine the implicit biases in public health practice and develop recommendations for education, training and research in this discipline using the application of a novel behavioural theory, multi-theory model (MTM) of health behaviour change. A review of literature in the MEDLINE, CINAHL, Google Scholar, and ERIC databases was performed to prepare this article. The constructs of participatory dialogue in which advantages outweigh disadvantages, behavioural confidence, and changes in physical environment were discussed to initiate behaviour change devoid of implicit biases. The constructs of emotional transformation, practice for change and changes in social environment were discussed to sustain behaviour change devoid of implicit biases. Educational interventions based on MTM need to be adopted by Schools of Public Health in education of public health students and training of public health professionals. Such efforts will reduce implicit biases in the discipline of public health and improve quality of care.

Developing Multipronged Intervention Protocols for Childhood Obesity Prevention Based on Multi-Theory Model (MTM) of Health Behavior Change: A Mini Review

Developing Multipronged Intervention Protocols for Childhood Obesity Prevention Based on Multi-Theory Model (MTM) of Health Behavior Change: A Mini Review

Developing multipronged intervention protocols for childhood obesity prevention based on multi-theory model (MTM) of health behavior change: a mini review

Developing multipronged intervention protocols for childhood obesity prevention based on multi-theory model (MTM) of health behavior change: a mini review

Applying a new theory to smoking cessation: case of multi-theory model (MTM) for health behavior change

Background: Smoking continues to be a public health problem worldwide. Smoking and tobacco use are associated with cardiovascular diseases that include coronary heart disease, atherosclerosis, cerebrovascular disease, and abdominal aortic aneurysm. Programs for quitting smoking have played a significant role in reduction of smoking in the United States. The smoking cessation interventions include counseling, nicotine replacement therapy, buproprion therapy, and varenicline therapy. The success rates with each of these approaches vary with clear need for improvement. Moreover, there is a need for a robust theory that can guide smoking cessation counseling interventions and increase the success rates. A fourth generation approach using multi-theory model (MTM) of health behavior change is introduced in this article for smoking cessation. An approach for developing and evaluating an intervention for smoking cessation is presented along with a measurement tool. Methods: A literature review reifying the MTM of health behavior change for smoking cessation has been presented. An instrument designed to measure constructs of MTM and associated smoking cessation behavior has been developed. Results: The instrument developed is available for validation, reliability and prediction study pertaining to smoking cessation. The intervention is available for testing in a randomized control trial involving smokers. Conclusion: MTM is a robust theory that holds promise for testing and application to smoking cessation.

Applying Multi-Theory Model (MTM) of Health Behavior Change to Predict Water Consumption Instead of Sugar-Sweetened Beverages.

A substantial proportion of college students to not drink enough water and consume sugar-sweetened beverages (SSBs). Consumption of SSBs is associated with weight gain, obesity, type 2 diabetes mellitus, dental carries, and increased risk for cardiovascular disease. Hence, the purpose of this study was to use the multi-theory model (MTM) in predicting initiation and sustenance of plain water consumption instead of sugar-sweetened beverages among college students. A cross-sectional study. In this cross-sectional study, a 37-item valid and reliable MTM-based survey was administered to college students in 2016 via Qualtrics at a large public university in the Southeastern United States. Overall, 410 students responded to the survey; of those, 174 were eligible for the study and completed it. Stepwise multiple regression analysis revealed that 61.8% of the variance in the initiation of drinking plain water instead of SSBs was explained by behavioral confidence (P<0.001) and changes in the physical environment (P<0.001). Further, 58.3% of the variance in the sustenance of drinking plain water instead of SSBs was explained by emotional transformation (P<0.001) and practice for change (P=0.001). Multi-theory model of health behavior change is a robust theory for predicting plain water consumption instead of SSBs in college students. Interventions should be developed based on this theory for this target population.

Applying a New Theory to Alter Binge Drinking Behavior in College Students.

Binge drinking is a serious public health problem in the United States, where it is estimated that 17.6% adults binge drink. Binge drinking is highest among college students. There is need for effective binge drinking interventions. Recently a new health behavior theory has been proposed called the multitheory model of health behavior change. The purpose of this article is to describe the application of the multitheory model for changing binge drinking behavior to a behavior of responsible drinking or abstaining from alcohol. A framework for an intervention and its testing is presented.

Using Multitheory Model of Health Behavior Change to Predict Adequate Sleep Behavior.

The purpose of this article was to use the multitheory model of health behavior change in predicting adequate sleep behavior in college students. A valid and reliable survey was administered in a cross-sectional design (n = 151). For initiation of adequate sleep behavior, the construct of behavioral confidence (P < .001) was found to be significant and accounted for 24.4% of the variance. For sustenance of adequate sleep behavior, changes in social environment (P < .02), emotional transformation (P < .001), and practice for change (P < .001) were significant and accounted for 34.2% of the variance.

Self-Regulatory Mechanisms of Doping Intentions in Elite Athletes: The Role of Self-Determined Motivation in Sport

Objective: Although research on the personal and psychosocial predictors of doping has been extensive, the factors related to the socio-cognitive self-regulatory mechanisms of doping remain unexplored. The aim of this study was to test an integrated multi-theory model examining the role of self-determined motivation in sport in the self-regulatory mechanisms of doping intentions in elite athletes. Methods: A cross-sectional survey was employed. Two hundred and sixty-four elite athletes completed a survey that included measures of self-determination (autonomous vs. controlled), affective self-regulatory efficacy, resistive self-regulatory efficacy, moral disengagement, and doping intentions. Results: Structural equation modeling showed that the model predicted 47.3% of the variance in doping intentions and indicated that both autonomous and controlled motivations were indirectly associated with doping intentions through the mediating role of affective self-regulatory efficacy, resistive self-regulatory efficacy, and moral disengagement. Conclusion: Self-determination theory provides insight into how motivation in sport influences athletes’ doping intentions through its impact on socio-cognitive self-regulatory mechanisms.

Using multi-theory model to predict initiation and sustenance of small portion size consumption among college students.

Background: Consumption of large portion sizes is contributing to overweight and obesity.College students are a vulnerable group in this regard. The purpose of this study was to use multi-theory model (MTM) to predict initiation and sustenance of small portion size consumption in college students. Methods: A total of 135 students at a large Southern US University completed a 35-item valid (face, content, and construct) and reliable (internally consistent) survey electronically in a cross-sectional design. The main outcome measures were intention to start eating small portion sizes and continuing to eat small portion sizes. Only those students who ate large portion sizes during the past 24 hours were included. Results: Step wise multiple regression showed that initiation of small portion size consumption was explained by participatory dialogue (advantages outweighing disadvantages), behavioral confidence, age, and gender (adjusted R2 = 0.37, P < 0.001). Males were less likely to initiate small portion size consumption than females (β = -0.185, 95% CI = -0.71– -0.11). Regarding sustenance, emotional transformation, changes in social environment, and race were the significant predictors (adjusted R2 = 0.20, P < 0.001). Whites were less likely to sustain small portion size change than other races (β = -0.269, 95% CI = -0.97 – -0.26). Conclusion: Based on this study’s findings, MTM appears to be a robust theoretical framework for predicting small portion size consumption behavior change. Interventions in this regard need to be designed.

Testing multi-theory model (MTM) in predicting initiation andsustenance of physical activity behavior among college students

Background: Most college students do not adequately participate in enough physical activity (PA) to attain health benefits. A theory-based approach is critical in developing effective interventions to promote PA. The purpose of this study was to examine the utility of the newly proposed multi-theory model (MTM) of health behavior change in predicting initiation and sustenance of PA among college students. Methods: Using a cross-sectional design, a valid and reliable survey was administered in October 2015 electronically to students enrolled at a large Southern US University. The internal consistency Cronbach alphas of the subscales were acceptable (0.65-0.92). Only those who did not engage in more than 150 minutes of moderate to vigorous intensity aerobic PA during the past week were included in this study. Results: Of the 495 respondents, 190 met the inclusion criteria of which 141 completed the survey. The majority of participants were females (72.3%) and Caucasians (70.9%). Findings of the confirmatory factor analysis (CFA) confirmed construct validity of subscales (initiation model: χ2 = 253.92 [df = 143], P < 0.001, CFI = 0.91, RMSEA = 0.07, SRMR = 0.07; sustenance model: χ2= 19.40 [df = 22], P < 0.001, CFI = 1.00, RMSEA = 0.00, SRMR = 0.03). Multivariate regression analysis showed that 26% of the variance in the PA initiation was explained by advantages outweighing disadvantages, behavioral confidence, work status, and changes in physical environment. Additionally, 29.7% of the variance in PA sustenance was explained by emotional transformation, practice for change, and changes in social environment. Conclusion: Based on this study’s findings, MTM appears to be a robust theoretical framework for predicting PA behavior change. Future research directions and development of suitable intervention strategies are discussed.