Positive Outcome Expectancies Research Articles

Predictors of adherence to a physical activity counseling intervention delivered by exercise physiologists: secondary analysis of the NewCOACH trial data.

BackgroundGeneral practitioners (GPs) cite time as a barrier to physical activity counseling. An alternative for time-poor GPs in Australia is the referral of insufficiently active patients to exercise physiologists (EPs). As data on the predictors of adherence to physical activity counseling interventions are limited, this study aimed to identify the sociodemographic, medical, health, and psychological characteristics of insufficiently active primary care patients who adhered to a physical activity counseling intervention delivered by EPs.MethodsThis secondary analysis of data from the NewCOACH randomized trial used logistic regression to identify predictors of adherence, defined as patient participation in at least four of the five physical activity counseling sessions. EPs provided information about the number of sessions, while other potential predictors were obtained from the self-administered baseline questionnaire and medical summary sheets provided by the GPs.ResultsOf the 132 patients referred to an EP, 102 (77%) were adherent: 91 (69%) and eleven (8.3%) participated in all, or all but one, of the sessions, respectively. Of the remainder, seven (5.3%) patients participated in three sessions, seven (5.3%) participated in two sessions, five (3.8%) participated in one session, and eleven (8.3%) did not participate in any session. The odds of being adherent were 5.84 (95% CI 1.46–23.4, P≤0.05) times higher among retired participants than in those who were not in paid employment. The odds of being adherent 1) increased as the positive outcome expectation score increased (OR 1.89, 95% CI 1.12–3.18, P≤0.05) and 2) decreased as the duration (days) between referral and the initial counseling session increased (OR 0.95, 95% CI 0.92–0.98, P<0.01).ConclusionMore than three quarters of the patients participated in all, or all but one, of the sessions. Being retired, positive outcome expectations, and having a shorter wait between referral and the initial appointment predicted adherence.

Acculturative stress, social support, and career outcome expectations among international students

Framed by Social Cognitive Career Theory, the current study examined relationships between acculturative stress, social support from the host country, and career outcome expectations among international students in the United States of America (N = 555). Results indicated that acculturative stress was negatively related to social support and career outcome expectations. Additionally, decreased social support indirectly and partially explained relationships between acculturative stress and outcome expectations. Findings suggest that in order to promote more positive career outcome expectations for international students, counselors should not only address acculturative stress, but also its influence on host country social support.

Differences in Adolescents’ Response Decision and Evaluation for Face-to-Face and Cyber Victimization

The current study was designed to assess early adolescents’ response evaluation and decision for hypothetical peer victimization vignettes. Participants were 336 (59% girls; [Formula: see text] age = 12.55) seventh and eighth graders from one school in the Midwestern United States. Adolescents read a hypothetical online or offline social situation and answered questions designed to access internal congruence, response evaluation, response efficacy, emotional outcome expectancy, and social outcome expectancy. Girls were more likely to believe that aggressive responses online and offline would lead to positive social and emotional outcome expectancies when compared with boys. Adolescents were more likely to believe that offline and online aggressive responses were legitimate responses to face-to-face victimization, feel that aggressive responses online or offline were easier to execute in response to face-to-face victimization, and that aggressive responses online or offline would lead to positive emotions and better social outcomes.

Efficacy of a mobile phone-based life-skills training program for substance use prevention among adolescents: study protocol of a cluster-randomised controlled trial

BackgroundLife-skills trainings conducted within the school curriculum are effective in preventing the onset and escalation of substance use among adolescents. However, their dissemination is impeded due to their large resource requirements. Life-skills training provided via mobile phones might represent a more economic and scalable approach. The main objective of the planned study is to test the efficacy of a mobile phone-based life-skills training to prevent substance use among adolescents within a controlled trial.Methods/designThe efficacy of a mobile phone-based life-skills training to prevent substance use among adolescents will be tested in comparison to an assessment only control group, within a cluster-randomised controlled trial with two follow-up assessments after 6 and 18 months. The fully automated program is based on social cognitive theory and addresses self-management skills, social skills, and substance use resistance skills. Participants of the intervention group will receive up to 4 weekly text messages over 6 months in order to stimulate (1) positive outcome expectations, e.g., on using self-management skills to cope with stress, (2) self-efficacy, e.g., to resist social pressure, (3) observational learning, e.g. of interpersonal competences, (4) facilitation, e.g., of strategies to cope with negative emotions, and (5) self-regulation, e.g., by self-monitoring of stress and emotions. Active program engagement will be stimulated by interactive features such as quiz questions, message- and picture-contests, and integration of a friendly competition with prizes in which program users collect credits with each interaction. Study participants will be 1312 students between the ages of 14 and 16 years from approximately 100 secondary school classes. Primary outcome criteria will be problem drinking according to the short form of the Alcohol Use Disorders Identification Test and cigarette smoking within the last 30 days preceding the follow-up assessment at month 18.DiscussionThis is the first study testing the efficacy of a mobile phone-based life-skills training for substance use prevention among adolescents within a controlled trial. Given that this intervention approach proves to be effective, it could be easily implemented in various settings and would reach large numbers of young people in a cost-effective way.Trial registrationISRCTN41347061 (registration date: 21/07/2018).

A Closer Look at Descriptive Norms and Indoor Tanning: Investigating the Intermediary Role of Positive and Negative Outcome Expectations

ABSTRACTIndoor tanning is a risky behavior that dramatically increases skin cancer risk. Researchers from multiple disciplines aim to better understand this behavior to develop interventions and messages to curtail it. As such, we investigated the role of social norms and outcome expectations as predictors of tanning behavior as part of a larger test of constructs included in the Theory of Normative Social Behavior. In addition to offering additional empirical results to support theoretical claims for the importance of social norms and outcome expectations in predicting health behaviors, we offer indoor tanning-specific operationalizations in a conditional process model with the aim of assessing how content-specific measurements predict indoor tanning intentions. Results of a survey of adult indoor tanners from across the U.S. (N = 262) highlight when and how descriptive norms influence tanning intentions through the mediating roles of anticipatory socialization, injunctive norms, and health threat, and through the moderating role of mood-based tanning motivations. Implications for theory building as well as for intervention and message design are discussed.

PREVIEW study-influence of a behavior modification intervention (PREMIT) in over 2300 people with pre-diabetes: intention, self-efficacy and outcome expectancies during the early phase of a lifestyle intervention.

PurposeOnset of type 2 diabetes (T2D) is often gradual and preceded by impaired glucose homeostasis. Lifestyle interventions including weight loss and physical activity may reduce the risk of developing T2D, but adherence to a lifestyle change is challenging. As part of an international T2D prevention trial (PREVIEW), a behavior change intervention supported participants in achieving a healthier diet and physically active lifestyle. Here, our aim was to explore the influence of this behavioral program (PREMIT) on social-cognitive variables during an 8-week weight loss phase.MethodsPREVIEW consisted of an initial weight loss, Phase I, followed by a weight- maintenance, Phase II, for those achieving the 8-week weight loss target of ≥ 8% from initial bodyweight. Overweight and obese (BMI ≥25 kg/m2) individuals aged 25 to 70 years with confirmed pre-diabetes were enrolled. Uni- and multivariate statistical methods were deployed to explore differences in intentions, self-efficacy, and outcome expectancies between those who achieved the target weight loss (“achievers”) and those who did not (“non-achievers”).ResultsAt the beginning of Phase I, no significant differences in intentions, self-efficacy and outcome expectancies between “achievers” (1,857) and “non-achievers” (163) were found. “Non-achievers” tended to be younger, live with child/ren, and attended the PREMIT sessions less frequently. At the end of Phase I, “achievers” reported higher intentions (healthy eating χ2(1)=2.57; P <0.008, exercising χ2(1)=0.66; P <0.008), self-efficacy (F(2; 1970)=10.27, P <0.005), and were more positive about the expected outcomes (F(4; 1968)=11.22, P <0.005).ConclusionAlthough statistically significant, effect sizes observed between the two groups were small. Behavior change, however, is multi-determined. Over a period of time, even small differences may make a cumulative effect. Being successful in behavior change requires that the “new” behavior is implemented time after time until it becomes a habit. Therefore, having even slightly higher self-efficacy, positive outcome expectancies and intentions may over time result in considerably improved chances to achieve long-term lifestyle changes.

Worry, anxiety sensitivity, and electronic cigarettes among adults

Although electronic cigarette (e-cigarette) use is now a common substance use behavior, there is little understanding of the individual difference factors related to e-cigarette use beliefs and dependence. The present investigation sought to test a theoretically-driven model of anxiety sensitivity as an explanatory element in a worry-e-cigarette beliefs and dependence model. Participants included 558 adult e-cigarette users (51.4% female; 35.2 years, SD = 10.1) who were nationally recruited via an online survey system. Participants completed a single survey that assessed their mood and e-cigarette behavior and beliefs. Results supported a statistically significant indirect pathway for worry in relation to perceived benefits of e-cigarettes, e-cigarette positive outcome expectancies, and e-cigarette dependence via anxiety sensitivity; effect sizes were small. The indirect effects were evident when accounting for several theoretically relevant covariates (sex, income, education, concurrent cigarette use, and neuroticism). This study provides the first empirical evidence of the role of anxiety sensitivity in the relation between worry and e-cigarette use beliefs and behavior, which may represent a novel intervention target.

Succumb to habit: Behavioral evidence for overreliance on habit learning in Internet addicts

Studies of Internet addiction (IA) under the cognitive-behavioral framework have suggested that IA derived from the excessive expectation of positive outcomes, which was a goal-directed behavioral progress. However, according to the dual-system account under the framework of associative learning theory, IA should be considered as a transition process from goal-directed to habit-based. It can be explained in terms of aberrant learning processes, where Internet addicts apparently succumb to habit with decreased sensitivity to reward devaluation. To test this hypothesis, we implemented an instrumental learning paradigm to investigate the difference of reliance on habit between Internet addicts and non-addicts. A total of 21 Internet addicts and 23 normal control subjects were trained in the first experimental phase and learned to associate stimuli with rewarding outcomes by pressing correct keys. In the subsequent outcome devaluation test and in the stimulus-response (S-R) habit test, subjects were required to adjust responses to changes in the value of current outcomes. Results revealed that (1) all subjects were able to gradually acquire the correct behavioral responses in the training phase, however, (2) extensive training rendered Internet addicts less sensitive to outcome devaluation in the outcome devaluation test, and (3) Internet addicts insisted on responding to previous stimuli in the S-R habit test, regardless of whether their responses were rewarded. Thus, we conclude that Internet addicts have an enhanced propensity to develop stimulus-driven habits and overly rely on it, leading to the failures to adjust behavior during goal reevaluation.

(Un)Great Expectations: The Role of Placebo Effects in Cognitive Training

A growing body of literature demonstrating the malleability of critical higher-order cognitive functions by means of targeted interventions has incited widespread scientific interest, most notably in the form of cognitive training programs. The results are mixed and a point of contention: It has been argued that gains observed in cognitive training are mainly due to placebo effects. To address this, we examined the effect of participant expectations on one type of cognitive training that has been central to the controversy, namely n-back training, by inducing beliefs about expected outcomes. Participants receiving n-back training showed improvements in non-trained n-back performance regardless of expectations, and furthermore, expectations for positive outcomes did not result in any significant gains in an active control group. Thus, there was no detectable expectancy effect in either direction as a function of the cognitive intervention used, suggesting that training-related improvements are unlikely due solely to a placebo effect.

Positive outcome expectancy mediates the relationship between social influence and Internet addiction among senior high-school students.

Background and aimsBased on the foundations of Bandura’s social cognitive theory and theory of triadic influence (TTI) theoretical framework, this study was designed to examine the mediating role of positive outcome expectancy of Internet use in the relationship between social influence and Internet addiction (IA) in a large representative sample of senior high-school students in Taiwan.MethodsUsing a cross-sectional design, 1,922 participants were recruited from senior high schools throughout Taiwan using both stratified and cluster sampling, and a comprehensive survey was administered.ResultsStructural equation modeling and bootstrap analyses results showed that IA severity was significantly and positively predicted by social influence, and fully mediated through positive outcome expectancy of Internet use.Discussion and conclusionsThe results not only support Bandura’s social cognitive theory and TTI framework, but can also serve as a reference to help educational agencies and mental health organizations design programs and create policies that will help in the prevention of IA among adolescents.

Peer norms and susceptibility mediate the effect of movie alcohol exposure on alcohol initiation in adolescents.

Movie alcohol exposure is a known and consistent predictor of adolescent alcohol use initiation and escalation. Nearly 90% of the top U.S. movies contain alcohol content. Social-cognitive theory posits reciprocal links among environmental influences (e.g., movie alcohol exposure), social-cognitive processes (e.g., perceived norms, susceptibility, alcohol outcome expectancies), and behavior (alcohol use), but these links have been tested in only 1 direction. In the current study, we assessed movie alcohol exposure, alcohol cognitions, and alcohol initiation among adolescents (N = 1,023; 52% female, mean age = 13.7 years) in 4 annual survey waves. Cross-lagged panel models tested bidirectional relations between cognitions and movie alcohol exposure. Finally, we tested bidirectional mediation effects in the prospective prediction of alcohol initiation. Movie alcohol exposure prospectively predicted increases in descriptive norms, injunctive norms, and susceptibility but not positive or negative alcohol outcome expectancies. All factors predicted subsequent alcohol initiation. Close friend injunctive and descriptive norms, peer descriptive norms, and susceptibility mediated the effect of earlier movie alcohol exposure on subsequent alcohol initiation. Movie alcohol exposure mediated the effect of earlier close friend descriptive norms on subsequent alcohol initiation. Movie alcohol exposure and social-cognitive processes are interrelated facets that impact alcohol initiation. Permissive cognitions infrequently predicted higher subsequent exposure to movie alcohol. Clinical and preventative implications of this work are discussed. (PsycINFO Database Record

Positive Expectancies for E-Cigarette Use and Anxiety Sensitivity Among Adults.

Although e-cigarette use is on the rise among youth and adults, there is little understanding of the individual difference factors at a cognitive level of analysis for e-cigarette beliefs and quit behavior. The present investigation sought to test a theoretically driven interactive model of positive expectancies for e-cigarettes and anxiety sensitivity (fear of the consequences of anxiety) among 551 adult e-cigarette users (50.6% female, Mage = 35.2 years, SD = 10.1). Results indicated a significant interaction between positive expectancies for e-cigarette use and AS was significantly related to greater perceived benefits of e-cigarette use, greater perceived risk of e-cigarette use, and more serious attempts for trying to quit e-cigarettes. The significant interaction effect for each dependent variable was evident over and above the main effects as well as the covariates of sex, income, education, and concurrent combustible cigarette use. The form of this interaction indicated that e-cigarette users higher in AS who also maintained more positive outcome expectancies for e-cigarette use reported more perceived benefits as well as more perceived risk of e-cigarette use and engaged in more (failed) attempts to quit e-cigarettes. Overall, the current data suggest that individual differences in AS and positive expectancies may represent two important factors to consider in e-cigarette beliefs and quit attempts. This study provides the first empirical evidence of a transdiagnostic construct (anxiety sensitivity) in relation to e-cigarette use and how it interplays with positive expectancies for e-cigarette use beliefs and behavior. These novel data suggest that future clinical research may benefit by understanding the potential therapeutic role of anxiety sensitivity and expectancies for e-cigarette use behavior.

Psychometric properties and factor structure of the adapted Self-Regulation Questionnaire assessing autonomous and controlled motivation for healthful eating among youth with type 1 diabetes and their parents.

The purpose of this cross-sectional study was to examine the psychometric properties of 2 adapted Self-Regulation Questionnaire (SRQ) measures assessing youth with type 1 diabetes motivation internalization for healthful eating and their parents motivation internalization for providing healthy meals for the family. External validity of the adapted SRQ was evaluated with respect to healthy eating attitudes (healthful eating self-efficacy, barriers, and outcome expectations) assessed by questionnaire, diet quality (Healthy Eating Index-2005 [HEI-2005]; Nutrient-Rich Foods Index 9.3 [NRF9.3]; Whole Plant Food Density [WPFD]) assessed by 3-day food records, and body mass index assessed by measured height and weight in youth with type 1 diabetes (N=136; age 12.3±2.5years) and their parents. Exploratory factor analysis with varimax rotation yielded a 2-factor structure with the expected autonomous and controlled motivation factors for both youth and parents. Internal consistencies of subscales were acceptable (α=.66-.84). Youth autonomous and controlled motivation were positively correlated overall (r=0.30, p<.001); however, in analyses stratified by age (<13 vs. ≥13years), the correlation was not significant for youth ≥13years. Autonomous motivation was significantly associated (p<.001) with greater self-efficacy (youth: r=0.39, parent: r=0.36), positive outcome expectations (youth: r=0.30, parent: r=0.35), and fewer barriers to healthful eating (youth: r=-0.36, parent: r=-0.32). Controlled motivation was positively correlated with negative outcome expectations for parents (r=0.29, p<.01) and both positive (r=0.28, p<.01) and negative (r=0.34, p<.001) outcome expectations for youth. Autonomous motivation was positively associated (p<.05) with diet quality indicators for parents (NRF9.3 r=0.22; WPFD r=0.24; HEI-2005 r=0.22) and youth ≥13years (NRF9.3 r=0.26) but not youth <13years. Among parents, but not youth, body mass index was associated negatively with autonomous motivation (r=-.33, p<.001) and positively with controlled motivation (r=.27, p<.01). Findings provide initial support for the SRQ in this population and suggest potential developmental differences in the role of motivation on healthful eating among children, adolescents, and adults.

Psychological factors related to nurses' intentions to initiate an antipsychotic or psychosocial intervention with nursing home residents

This study examined the validity of a psychological model for understanding nursing home providers' treatment choices when managing challenging dementia-related behaviors. Ninety-nine nurses from 26 long-term care facilities responded to a case study with their intentions to initiate an antipsychotic or psychosocial intervention and completed self-report measures of their attitudes, descriptive norms, self-efficacy, and outcome expectancies. The multi-level modeling results demonstrated that nurses with more positive outcome expectancies for the effect of an antipsychotic on resident behavior, and those with more positive attitudes towards antipsychotics, had greater intentions to initiate an antipsychotic. Intentions to initiate a psychosocial intervention were greater when nurses perceived a lower prevalence of antipsychotics and in facilities with nurses who collectively had higher self-efficacy to implement such interventions. The findings offer partial support for the proposed model and possible intervention targets to improve psychosocial intervention use and antipsychotic prescribing.

Microaggressions and Ethnic Identity in the Career Development of Latina College Students

Counseling psychologists have noted the importance of examining the intersection of sociocultural identity and vocational psychology. In our study, we considered this intersection in a sample of 202 Latina college and graduate students from a perspective informed by social cognitive career theory. We examined how ethnic identity and experiences of self-reported microagressions were related to career decision self-efficacy and outcome expectations, including relationships to both positive and negative outcome expectations in our model. Findings indicated that higher endorsement of ethnic identity was positively related to career decision self-efficacy and to negative outcome expectations, whereas higher endorsement of experiences of microaggressions was related to lower career-decision self-efficacy, greater negative outcome expectations, and lower positive outcome expectations. Career decision self-efficacy was associated with lower negative outcome expectations and higher positive outcome expectations. Indirect relationships and two alternative models were also explored. We discuss implications for future research and career counseling with Latinas.

Intervention planning for the REDUCE maintenance intervention: a digital intervention to reduce reulceration risk among patients with a history of diabetic foot ulcers

ObjectivesTo develop a comprehensive intervention plan for the REDUCE maintenance intervention to support people who have had diabetic foot ulcers (DFUs) to sustain behaviours that reduce reulceration risk.MethodsTheory-based, evidence-based and...

Trending on Pinterest: an examination of pins about skin tanning.

Rates of melanoma and nonmelanoma skin cancers are on the rise in the USA with data revealing disproportionate increase in female young adults. The popularity of intentional skin tanning among U.S. adolescents is attributed to several factors, including prioritization of physical appearance, media images of tanned celebrities, ease of availability of artificial tanning facilities, and more recently, the prevalence and celebration of tanned skin on social media. Pinterest, as the third most popular social media platform, was searched for "pins" about skin tanning. The resultant "pins" were examined to understand the extent and characteristics of skin tanning portrayed on Pinterest. We analyzed pins on Pinterest about skin tanning (n = 501) through a quantitative content analysis. Overall, results indicated an overwhelmingly protanning characteristic of pins about skin tanning on Pinterest, with over 85% of pins promoting tanning behavior. The pins were generally characterized by the portrayal of a female subject (61%) and provided positive reinforcement for tanning (49%). Use of tanning for enhancing appearance was the main positive outcome expectancy portrayed in the pins (35%), and nudity or exposure of skin on arms (32%) and legs (31%) was evident in about a third of pins. With overwhelmingly positive pins promoting tanning, use of female subjects, exhibiting nudity, and appearance enhancement, there seems be to a consistent targeting of female users to accept tanning as a socially acceptable and popular behavior. The findings indicate a need for developing sun protection messages and the leveraging of social media for dissemination of skin cancer prevention and detection messages.

Patients' perception and adherence to vaginal dilator therapy: a systematic review and synthesis employing symbolic interactionism.

BackgroundVaginal dilator (VD) therapy is often recommended for women receiving pelvic radiation therapy or experiencing pain and discomfort during intercourse, as well as for women with a congenital malformation of the vagina. VD use has both physical and psychological benefits; however, it often causes pain, discomfort, and adverse emotions, including embarrassment and loss of modesty, which often result in low adherence to therapy.ObjectivesThe aims of this study were to explore the use and adherence of VD therapy in women, identify barriers and facilitators of therapy adherence, and suggest improvement strategies from the theoretical perspective of symbolic interactionism.MethodsA systematic review of the literature was conducted using PubMed, CINAHL, and Scopus databases, with no year restrictions. Articles addressing the experience of women using VD therapy, as well as barriers and facilitators of therapy adherence were selected and analyzed. Then, the theoretical perspective of symbolic interactionism was introduced and applied to synthesize the results.ResultsA total of 21 articles were selected for the review. Most of the reviewed studies explored VD therapy in women who had undergone pelvic radiation therapy for gynecological cancer. Women’s adherence to the therapy ranged between 25% and 89.2%, with great variance in definitions and methods for assessing therapy adherence. Among the five categories of identified barriers to therapy adherence, “unhelpful circumstances” and “negative perceptions toward the VD” were the two most frequently mentioned. The two most frequently reported facilitators of adherence among the six identified categories were “supportive interactions with health care providers” and “risk perception and positive outcome expectancies”. On the basis of the perspective of symbolic interactionism, strategies for strengthening interactions with others (eg, health care providers, significant others, and support groups) are discussed in detail.ConclusionStrategic intervention regarding the decisive factors identified in the review can benefit women by enhancing their experience and adherence to VD therapy.

Feasibility of mobile health game “Fume” in supporting tobacco-related health literacy among early adolescents: A three-armed cluster randomized design

ObjectiveNew interventions supporting health literacy and a tobacco-free lifestyle in adolescence are needed to narrow the widening gap in existing health inequalities. Health games offer potential and could be utilized for example in school healthcare, but more research is needed to increase the understanding of the effects of game elements in health interventions. The aim of this feasibility study is to determine the short-term effectiveness of the tobacco-related mobile health game Fume and a non-gamified website in comparison with a no-intervention control group, regarding tobacco-related health literacy among 10–13-year-old early adolescents. In addition, we compare the demand for and acceptability of Fume to that of the website. MethodsIn total, 151 early adolescents participated in this single-blinded, three-armed cluster randomized trial. The participants from three municipalities in southwest Finland were randomly allocated between a group with access to the health game Fume (n = 61), a group with access to the website (n = 47), and a group with no intervention (n = 43). The intervention groups first participated in a 20-min training session with Fume/the website, and then had two weeks to use Fume/the website based on their own interest. Short-term effectiveness was measured by primary (anti-smoking self-efficacy) and secondary (smoking outcome expectations, attitudes towards tobacco use, tobacco-use motives, motivation to decline tobacco use in the future, and knowledge about tobacco) outcomes derived from the theory-based determinants of tobacco-related health literacy and evaluated with self-assessment questionnaires at baseline and post-intervention (after a two-week follow-up). For evaluating the demand, the actual use of Fume/the website was tracked during the two-week period. Regarding acceptability, the raised interest towards Fume/the website and opinions about the interventions were evaluated post-intervention. Differences were tested with the McNemar, Fisher exact, and non-parametric tests. ResultsStatistically significant favorable changes during the study period were found for positive (P = 0.002) and negative (P = 0.02) smoking outcome expectations and attitudes towards cigarette smoking (P = 0.01) within the group using Fume. No statistically significant changes were detected within the website or control groups. Statistically significant differences were not found for the change in outcome variables among the three groups. The number of visits (P < 0.001), number of separate visit days (P < 0.001) and total duration of use (P < 0.001) were larger for the group using Fume than for that using the website. Fume sparked more interest in early adolescents than the website did (P < 0.001). There were no statistically significant differences in opinions about Fume and those regarding the website. ConclusionsThe intervention with embedded game elements, the health game Fume, was found to be more feasible as a tobacco-related health education intervention than the non-gamified website among early adolescents in light of demand and acceptability (raised interest). Even though no change in anti-smoking self-efficacy was found, the results of this feasibility study demonstrated favorable short-term changes with Fume in some other theory-based determinants of tobacco-related health literacy.

Connecting2u Text Messaging Intervention: Connecting baby, family and community

Connecting2u (C2u) is an innovative health promotion intervention led by the Centre for Children’s Health and Wellbeing (CCHW), Children’s Health Queensland. It is oriented on the priority life stage of the ‘early years’ and used SMS as an mHealth strategy to encourage and support parenting self-efficacy, attachment, parent health behaviour and parenting practices. As a novel intervention, it was piloted in 2014 in Logan. In 2015-2017 it was trialled across four birthing hospitals in South-east Queensland. CCHW worked in collaboration with Griffith University (School of Medicine, Public Health), University of Newcastle (Family Action Centre), Mater Health Services, Metro-South Hospital and Health Services and a range of other health services and non-government organisation to determine the effectiveness of a family and infant health and wellbeing SMS intervention in supporting positive parenting behaviours in expectant and new parents birthing at partnered hospitals (Mater, Logan, Redlands, Beaudesert), in Queensland to influence children’s health and wellbeing. C2u is based on the Health Belief Model with text messaging as a cue to action and health behaviour change (Atun & Sittampalam, 2006). C2u uses the social cognitive theory constructs of self-efficacy and positive outcome expectations to inform the content of text messages to promote positive parenting practices (Evans, Wallace & Snider, 2012). Text messages are written from the baby’s perspective to align with project objectives of attachment between mother and father and their unborn baby or infant. Griffith University School of Medicine (Public Health) evaluated the intervention. The research was designed as a randomized controlled trial (RCT) and used both quantitative and qualitative research methods. A total of 602 mothers and 226 fathers participated in the project. Findings from the impact evaluation show that the C2u trial intervention resulted in the significant increase in maternal confidence of first time mothers during the postnatal phase of the study. This finding is supported by the process evaluation findings, where first time mothers believed that the C2u messages helped them to feel more confident in feeding, playing with and caring for their baby. Results from the process evaluation indicated that the SMS messages were well received by all mothers and fathers, particularly first time mothers and fathers, as they offered reliable, useful and relevant information in a convenient and timely manner. This confirms the importance of targeting the C2u intervention to first time parents who are new to the parenting experience and would benefit most from the intervention. Findings pertaining to the delivery of the C2u project show that participants found the project to be supportive, informative and well delivered. Overall, it appeared that the content and delivery of text messages were appropriate, and information gained by participants was being applied to share information with partners, strengthen parents’ connection with each other and their baby and to provide relief from the anxiety of new parenthood. Participants indicated that the text messages served as good reminders for things such as; what to take to the hospital, reminders about eating healthy, taking care of themselves and their partner and vaccination dates.