Precontemplation Stage Research Articles

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

Determinants of physical activity level of people living in rural areas according to the transtheoretical model: regression and path analysis.

This study investigates the relationship between the physical activities of adults living in rural areas and each component of the Transtheoretical Model. This descriptive and relational study was conducted with 315 individuals at a rural clinic in Turkey. Data were collected using tools for evaluating the Transtheoretical Model, and the International Physical Activity Questionnaire. Logistic regression analysis, multiple regression analysis, and path analysis were used in statistical analyses. Of the individuals living in rural areas, 59.1% were inactive, and 42.4% of the individuals were in the precontemplation stage. The mean exercise self-efficacy score was low, and pros subdimension of decisional balance was at an insufficient level. According to path analysis, perceived self-efficacy and stage of change for exercise were the variables that had a significant effect on physical activity (the metabolic equivalent of task score). The Transtheoretical Model is a strategic approach to improving exercise behavior in rural areas, and the prerequisites of health promotion such as enhancing education, income, and opportunities will contribute to the popularization of exercise.

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.

Safe bicycle riding scales based on the transtheoretical model for adolescents: Development and validation

BackgroundDeaths from bicycle transport have increased by 30% in the past 10 years. This should be considered a problem from various aspects for this reason. Safe bicycle riding concerns not just wearing a helmet; it involves a wide range of matters that must be considered. MethodsThe universe of the study, which is of development and validation design, consisted of fifth, sixth, seventh and eighth grade students (N = 503) enrolled in a middle school located in Istanbul during the 2017–2018 academic year. The data were collected with a 25-item questionnaire on sociodemographic features and bicycle riding behavior, and the Transtheoretical Model of scales. The adolescents in the study group were between the ages of 9–14; 49.5% were female, 50.5% were male. Used in testing for validity and reliability were the Content validity index, exploratory factor analysis, confirmatory factor analysis, floor-ceiling effect, Hotelling's T2, Standard Error of Measurement, the paired sample t-test, and Pearson's correlation. ResultsThe internal consistency reliability coefficients of the scales are α = 0.79 for the Cognitive Change Process Scale, α = 0.82 for the Behavioral Change Process Scale, α = 0.77 for the Pros Scale of Decisional Balance, α = 0.79 for the Cons Scale of Decisional Balance, α = 0.78 for the Self–Efficacy Scale.It was found that the Cons Scale of Decisional Balance mean score was under average, all other scale mean scores were above the average. Of the adolescents, 24.5% were in the precontemplation stage of change regarding safe bicycle riding in the Transtheoretical Model. ConclusionsAdolescents' safe bicycle riding behaviors can be evaluated by using scales that are valid and reliable. With the interventions to be implemented, changes can be achieved in safe bicycle riding behaviors and these changes can be screened with the Transtheoretical Model scales.

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.

Ready to roll: Strategies and actions to enhance organizational readiness for implementation in community mental health.

Organizational readiness for implementation (ORI) is a barrier to disseminating recovery-oriented evidence-based practices for people with severe mental illnesses. However, there is a knowledge gap regarding implementation strategies and specific actions related to those strategies that may enhance ORI across organizations. The Transtheoretical Model (TTM) is a well-established stage-based model used to support organizational change. In TTM, the first three stages-Pre-contemplation, Contemplation, and Preparation-represent the pre-implementation phase, during which ORI should be developed. This study explored ORI enhancement strategies reported as useful by different stakeholders in the field of community mental health (CMH) and tested the applicability of the TTM readiness stages as an organizing framework to direct ORI development. The study included the following two phases: (1) a qualitative exploration of ORI enhancement actions reported by various stakeholders in the CMH field (N = 16) based on their experience in successful implementation projects and (2) a consolidation process performed by the research team to create coherent groups of actions and their overarching implementation strategies per readiness stage. A comprehensive list of strategies and related actions was created. The strategies and actions correspond with each of the first three stages of the TTM. Stakeholders differed in their methods of facilitating engagement across the organization and in their level of involvement in developing ORI. This study is a first step in conceptualizing a systematic process for developing ORI using the TTM as a theoretical framework. Future studies should test the transferability and effectiveness of this repository to other implementation efforts, expend the lists per stage, and further explore differences between stakeholders' role in ORI development. Interventions that were proven effective in supporting the recovery of people with mental illnesses are not sufficiently available in the field of community mental health. One barrier to getting those interventions implemented is the lack of willingness and preparedness of organizations to change their practice, also referred to as organizational readiness for implementation (ORI). Little is known about how to enhance ORI to increase the availability of interventions. This study explored actions used to enhance ORI by people in different roles who successfully implemented new recovery-oriented interventions in community mental health settings. The actions were organized into three stages of readiness development based on the Transtheoretical Model (TTM) of behavioral change. Differences were found between administrators, consultants, supervisors, and providers in the type and number of strategies they described. The results show the applicability of the TTM as an organizing framework for ORI development and provide sets of strategies and specific actions to support different readiness needs across the organization.

Cognitive and affective empathy in men with alcohol dependence: Relation with clinical profile, abstinence, and motivation.

Background:Empathy plays a role not only in pathophysiology but also in planning management strategies for alcohol dependence; however, few studies have looked into it. No data are available regarding the variation of empathy with abstinence and motivation. Assessment based on cognitive and affective dimensions of empathy is needed.Aim:This study aimed to assess cognitive and affective empathy in men with alcohol dependence and compared it with normal controls. Association of empathy with disease-specific variables, motivation, and abstinence was also done.Methods:This was a cross-sectional observational study conducted in the outpatient department of a tertiary care center. Sixty men with alcohol dependence and 60 healthy controls were recruited and assessed using the Basic Empathy Scale for cognitive and affective empathy. The University of Rhode Island Change Assessment Scale was used to assess motivation. Other variables were assessed using a semi-structured pro forma. Comparative analysis was done using unpaired t-test and one-way ANOVA. Correlation was done using Pearson's correlation test.Results:Cases with alcohol dependence showed lower levels of cognitive, affective, and total empathy as compared to controls. Affective and total empathy were higher in abstinent men. Empathy varied across various stages of motivation, with a significant difference seen between precontemplation and action stages. Empathy correlated negatively with number of relapses and positively with family history of addiction.Conclusions:Empathy (both cognitive and affective) is significantly reduced in alcohol dependence. Higher empathy correlates with lesser relapses. Abstinence and progression in motivation cycle is associated with remission in empathic deficits.

Relationship between Cognitive-Behavioral Processes and Stages of Change in Nutrient Use in Overweight Women Referring to Health Centers in Isfahan.

Background:The positive impact of post-needs assessment training on the correction of eating habits is remarkable. The aim of present study was to determine the relationship between cognitive-behavioral processes and stages of change in nutrient use in overweight women referring to health centers in Isfahan.Materials and Methods:The present study was a cross-sectional study conducted in 2017 during a three-month period. Using systematic random sampling, 260 overweight women referring to Isfahan comprehensive health centers were chosen. Data collection was performed by a four-part researcher-made questionnaire including demographic information form, stages of change of behavior, cognitive and behavioral processes questionnaire, and standard 168-item Food Frequency Questionnaire. After confirming its validity and reliability, it was completed by the researcher. Data were then entered N4 software perfect and analyzed using descriptive and analytical tests (ANOVA and Bonferroni Post-Hoc).Results:59.30% of the subjects were in an inactive and 40.70% in an active phase. There was a significant difference with respect to different stages of change and the use of all behavior change processes (F4= 11.42, p < 0.001). The rate of using cognitive and behavioral processes increased during the nutrient change behavior (p < 0.001).Conclusions:The results of the study showed that moving away from pre-contemplation stage to maintenance phase increases the rate of using these processes that is due to the stability and improvement of changed behavior. Therefore, health plans should be designed based on the stage of the target group.

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.

Do Health Professionals Sufficiently Address Patients' Disposition Toward Changing Their Nutritional and Physical Activity Habits? Findings from a Pilot Study among People with Type 2 Diabetes in Northern Italy.

The aim of our study was to evaluate the disposition of individuals with type 2 diabetes mellitus (DM2) toward changing their nutritional and physical activity habits and associated factors—particularly their perceptions about interacting and communicating with four health professions. Working with a local patients’ association, we invited 364 individuals with DM2, all at least 18 years old, to complete a paper-based survey with questions addressing their experiences of interacting and communicating with general practitioners, nurses, dieticians and diabetologists and about their readiness to change targeted habits, their health literacy and their clinical status. Of the 109 questionnaires collected, 100 were eligible for descriptive and inferential statistical analysis. Regarding nutritional habits, the highest percentage of participants were at the maintenance stage (26%), whereas regarding physical activity habits the highest percentage of participants were at the preparation stage (31%). Significant differences between the habits emerged for four of the five stages and for two psychological processes. The precontemplation stage was most associated with communication-related variables, whereas the maintenance stage was associated with higher health literacy for both habits, and waist-to-height ratio was associated with several stages of change and psychological processes for physical activity habits. Considering aggregated stages (i.e., active or passive stage), significant differences were observed for all psychological processes except readiness to change nutritional habits. Logistic regression analysis revealed associations of the active stage with higher self-efficacy and lower discrepancy processes for both habits. Nutritional habits were associated with normal HbA1c values and physical activity habits with high cholesterol. Understanding the combination of the stages of change and how they relate to psychological processes can afford meaningful insights into the potential internal and external communication skills of health professions and should be examined as possible elements for a patient evaluation model.

Advance Care Planning Engagement Among Muslim Community-Dwelling Adults Living in the United States.

Advance care planning (ACP) is a cornerstone of self-determination for the type of care provided at the end of life. Despite many national efforts to improve American adults' engagement in ACP, statistics indicate low engagement. Low engagement, especially among racial and ethnic minority populations, immigrants, people with lower socioeconomic status, young adults, rural residents, or non-English speakers, is common. Advance care planning engagement among Muslims living in the United States has been minimally studied. The purpose of this study was to explore Muslims' engagement in ACP. A cross-sectional descriptive design was used. Participants were recruited from Islamic organizations through convenience and snowball sampling. Engagement in ACP was measured by the Advance Care Planning Engagement Survey. A sample of 148 Muslims (18-79 years of age) participated in the study. The average engagement scores ranged from 1.97 to 2.09, with about two-thirds in the precontemplation stage. Significant differences in engagement scores were found according to health condition and end of life experiences. Results suggest a need for further collaborative efforts by health care providers, policymakers, and researchers to mitigate the disparities in ACP engagement in the American Muslim community.

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.

Meat reduction, vegetarianism, or chicken avoidance: US omnivores’ impressions of three meat-restricted diets

PurposeMeat consumption has a variety of implications in society. While various types of meat-restricted diets exist to address this, not enough is known about how the average meat consumer views different avenues to lessening their intake. In response, this study aims to assess US omnivores’ impressions of three meat-restricted diets.Design/methodology/approachAn online survey was administered to a cross-sectional, census-balanced sample from Nielsen of 30,000+ US adults. Omnivores (N = 928) were randomized into one of the three conditions where they were asked about their perceptions of a vegetarian diet, a reduced-meat diet or a chicken-free diet as individuals not currently following that dietary pattern.FindingsThe findings showed that omnivores had a more favorable perception of a reduced-meat diet on a greater number of study variables as compared to the vegetarian or chicken-free diets. The research also demonstrated that a majority of omnivores were in the precontemplation stage of cognitive change, suggesting that most American omnivores are not actively demonstrating a readiness to alter their meat consumption in the ways presented.Originality/valueThis research is the first to examine the comparative trends around these three diets among omnivores. It also speaks to how the desirability of meat restriction varies by type of approach, i.e. elimination or reduction, and if the latter, what type. The findings may be of relevance for efforts to reduce global meat consumption for ethical, health, or environmental reasons.

Identifying stages of smoke and smokeless tobacco cessation among adults in India: an application of transtheoretical model

ABSTRACT Introduction In this paper, we used the transtheoretical model of stages of change to study the addictive behavior of smokers, which is a continuum of stages, namely pre-contemplation, contemplation, and preparation, and classify the tobacco users in these three stages to study the differentials and factors determining these stages. Data and Methodology This study used the data from the Global Adult Tobacco Survey (GATS)-2 conducted in 2016–17 in India. Multinomial logistic regression was used to predict the probabilities for different stages according to socio-demographic factors and factors related to tobacco use such as nicotine dependency, information about dangers about tobacco use, etc. Results Among 9499 smoking tobacco users, 44.73% of users are in the pre-contemplation stage, 46.83% in contemplation, and only 8.43% in the preparation stage. The probability of a smoker to be in the preparation stage for quitting after knowing the dangers of smoking is 0.11. Conclusion We found a significant association between the stages of smoke and smokeless tobacco cessation and socio-demographic characteristics and the factors related to smoke and smokeless tobacco use. Contemplation is a major driver of tobacco cessation. These stages may help tobacco control program implementation more effectively and efficiently.

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

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.

금주행위 변화단계별 변화과정, 의사결정 균형 및 자기효능감의 관계

Objective: This study aimed to identify the relationships between processes of change, decisional balance and self-efficacy by stages of change in abstinence behavior among users of community addiction management centers in Korea. Based on the findings, it also aimed to provide basic data to develop effective recovery support programs for community addiction management centers and establish addiction prevention policies. Methods: The subjects of this study are 141 users aged 20 or older who are registered under the Community Addiction Management Center of S-gu in G City. Data were collected using self-report surveys on stages of change, processes of change, decisional balance and self-efficacy for alcohol abstinence. The collected data were analyzed using SPSS/WIN 23.0. Results: In terms of the distribution of stages of change in abstinence, 57.5% fell under the maintenance stage, and the processes of change by stages of change showed that those in the maintenance stage had higher scores than those in the precontemplation stage. The scores of cognitive processes were higher at the beginning stages, and the scores of behavioral processes were higher at later stages. The decisional balance of alcohol abstinence showed high levels of awareness of the damages from drinking, and there were significant differences in abstinence self-efficacy by stages of change. Positive correlations were found between stages of change and self-efficacy. For processes of change of alcohol abstinence, the cognitive processes showed positive correlations with the behavioral processes and the decisional balance loss factor, and the behavioral processes had positive correlations with the decisional balance loss factor. In terms of the decisional balance, the benefit factor had negative correlations with self-efficacy. Conclusion: It is necessary to establish strategies on processes of change by considering stages of change in abstinence by users, and develop local community-based alcoholic intervention programs that emphasize the harmfulness of drinking and reinforce self-efficacy. Furthermore, there should be political support to develop such programs and strategies.

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.