Understanding Health Behavior Research Articles

Social network characteristics and their relationships with physical activity in children with multiple sclerosis

BackgroundPhysical activity has been found to associate with improved health outcomes in children with multiple sclerosis (MS). Social networks may facilitate physical activity in children with MS. ObjectivesTo estimate associations between social network characteristics and physical activity in children with MS compared to children with monophasic acquired demyelinating syndrome (mono-ADS). MethodsChildren with MS and mono-ADS recruited from the Hospital for Sick Children completed questionnaires on social network and physical activity. Descriptive and inferential analyses estimated differences between cohorts and correlations. ResultsChildren with MS (n = 16) and mono-ADS (n = 22) did not differ in outcomes. Higher physical activity associated with larger social networks (rs= 0.681, p < 0.01), more Emotional Support (rs= 0.604, p < 0.05), Camaraderie (rs= 0.585, p < 0.05), more social network members with post-secondary education (rs= 0.680, p < 0.05), and members who exercise 3 to 4 times a week (rs= 0.744, p < 0.01). These associations were not found in children with mono-ADS. ConclusionLarger social network size, more emotional support and camaraderie, and more individuals with post-secondary education and who regularly exercise in the social network associated with higher physical activity in children with MS. Social network characteristics may help understand health behaviors in children with MS.

Older adults’ compliance with mobile ecological momentary assessments in behavioral nutrition and physical activity research: pooled results of four intensive longitudinal studies and recommendations for future research

BackgroundMobile Ecological Momentary Assessment (EMA) is increasingly used to gather intensive, longitudinal data on behavioral nutrition, physical activity and sedentary behavior and their underlying determinants. However, a relevant concern is the risk of non-random non-compliance with mobile EMA protocols, especially in older adults. This study aimed to examine older adults’ compliance with mobile EMA in health behavior studies according to participant characteristics, and prompt timing, and to provide recommendations for future EMA research.MethodsData of four intensive longitudinal observational studies employing mobile EMA to understand health behavior, involving 271 community-dwelling older adults (M = 71.8 years, SD = 6.8; 52% female) in Flanders, were pooled. EMA questionnaires were prompted by a smartphone application during specific time slots or events. Data on compliance (i.e. information whether a participant answered at least one item following the prompt), time slot (morning, afternoon or evening) and day (week or weekend day) of each prompt were extracted from the EMA applications. Participant characteristics, including demographics, body mass index, and smartphone ownership, were collected via self-report. Descriptive statistics of compliance were computed, and logistic mixed models were run to examine inter- and intrapersonal variability in compliance.ResultsEMA compliance averaged 77.5%, varying from 70.0 to 86.1% across studies. Compliance differed among subgroups and throughout the day. Age was associated with lower compliance (OR = 0.96, 95%CI = 0.93–0.99), while marital/cohabiting status and smartphone ownership were associated with higher compliance (OR = 1.83, 95%CI = 1.21–2.77, and OR = 4.43, 95%CI = 2.22–8.83, respectively). Compliance was lower in the evening than in the morning (OR = 0.82, 95%CI = 0.69–0.97), indicating non-random patterns that could impact study validity.ConclusionsThe findings of this study shed light on the complexities surrounding compliance with mobile EMA protocols among older adults in health behavior studies. Our analysis revealed that non-compliance within our pooled dataset was not completely random. This non-randomness could introduce bias into study findings, potentially compromising the validity of research findings. To address these challenges, we recommend adopting tailored approaches that take into account individual characteristics and temporal dynamics. Additionally, the utilization of Directed Acyclic Graphs, and advanced statistical techniques can help mitigate the impact of non-compliance on study validity.

Health behavior inventory – short form: a Chinese validation study using classical test theory and item response theory

BackgroundIt is imperative to use a validated tool to measure and understand health behavior as it greatly impacts health status. It has been demonstrated that the Health Behavior Inventory - Short Form (HBI-SF) is valid in several countries. The purpose of this study was to translate the HBI-SF into Chinese and test its psychometric properties.MethodsThis study employed a two-phase methodology. The phase one entailed the cross-cultural adaptation of the HBI-SF, while the subsequent phase evaluated the psychometric properties of the scale. This evaluation encompassed classical test theory (CTT) and item response theory (IRT) tests to assess reliability and validity. It involved 1058 participants, of whom 1036 completed the questionnaire successfully. Out of these, 518 were analyzed for CTT, along with 518 for IRT.ResultsThe S-CVI was found to be 0.935, while the I‐CVI ranged from 0.889 to 1.000. The results of the confirmatory factor analysis suggested the goodness-of-fit indices for the four-factor model was acceptable. Regarding the subscales, the average variance extracted (AVE) and Heterotrait-Monotrait Ratio of Correlations (HTMT) matrix also met the cutoff values (AVE > 0.5 and HTMI < 0.85). Furthermore, the internal consistency and composite reliability indices of all factors were greater than 0.7. Infit and/or outfit values indicated that all items fitted the Rasch model. The Wright map revealed that the average person measures for the participants (mean = − 0.994, SD = 0.430) were comparatively lower than the average item measures (mean = 0.000, SD = 0.257). The person separation reliability values for the four factors ranged from 0.600 to 0.746, indicating an acceptable level of reliability. Two items showed differential item functioning.ConclusionsThe findings derived from both CTT and IRT analyses demonstrate favorable levels of reliability and validity for the Chinese version of the HBI-SF.

The Everyday Wellbeing Appraisal Scale: Assessing a type of subjective well-being uniquely associated with health behavior in people with hypertension.

Everyday well-being appraisals are judgments about the goodness of recent daily life events. These appraisals are expected to be distinct from other types of well-being involving traits, affect, and psychological distress and expected to be uniquely important for understanding health behavior such as exercise, diet, and treatment adherence for people with medical conditions. To develop and test a new Everyday Wellbeing Appraisal Scale, two studies were conducted in which a total of 718 people with hypertension completed online questionnaires. In Study 1, to achieve maximum validity with the fewest number of items, an empirical analysis was used to select a set of six items with high discrimination that incorporated multiple types of response-option formats. In Study 2, the scale's unidimensional factor structure and high discrimination were confirmed, and the new scale outperformed several existing types of well-being scales in its ability to explain unique variance in health behavior criterion variables. Specifically, it explained unique variance in health behavior after controlling for a widely used measure assessing trait-level reflections of well-being, as well as measures of positive affect and two types of psychological distress. Also, when compared to the trait-level measure of well-being, the new scale demonstrated less overlap with affect and psychological distress. These results suggest that this brief, new scale is valuable for assessing a distinct construct that is especially salient for understanding health behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Island Health Crisis: Bridging Gaps in Indonesia's Healthcare Deserts

This narrative literature review examines critical healthcare challenges in Indonesia's island communities, focusing on workforce shortages, inadequate health infrastructure, and the profound impact of geographical and socioeconomic factors. Drawing from eight studies published between January 2000 and December 2023, the discussion highlights both the strengths and weaknesses of existing research. The studies were selected based on their relevance to healthcare issues in island communities, rigorous methodological approaches, and significant insights into healthcare challenges and solutions. This time frame was chosen to encompass a comprehensive evolution of healthcare challenges and responses, particularly considering the effects of the COVID-19 pandemic. Grounded in the Diffusion of Innovations and Health Belief Model frameworks, the study proposes evidence-based strategies to enhance healthcare accessibility and quality in these underserved regions. The Health Belief Model is employed to understand health behaviors within island communities, addressing perceived susceptibility, severity, benefits, and barriers. Strategies include increasing awareness of health risks, highlighting the benefits of telemedicine and improved infrastructure, and reducing access barriers through incentives and infrastructural enhancements. In contrast to, The Diffusion of Innovations Theory guides the dissemination of new healthcare practices and technologies. Emphasizing innovation attributes such as relative advantage, simplicity, trialability, and observability, and utilizing effective communication channels and local social systems. The study aims to promote the adoption of telemedicine and other innovations. By engaging community leaders and health workers, and considering the time needed for adoption, the proposed recommendations aim to accelerate the diffusion process, ultimately improving healthcare accessibility and outcomes in Indonesia's island communities.

Understanding health behaviors that modify the risk for obesity in ADHD.

Research provides support for the associated risk of inadequate sleep duration, limited physical activity, and excessive media use in attention-deficit/hyperactivity disorder (ADHD) and obesity. The present study aims to (1) examine the association between ADHD and overweight or obese status (OW/OB); (2) comprehensively examine sleep duration, physical activity, and media use as potential moderators of OW/OB; and (3) examine the moderating effects of these health behaviors cross-sectionally by comparing medicated youth with ADHD, unmedicated youth with ADHD, and youth without ADHD. Data were acquired from the 2018 and 2019 National Survey of Children's Health, a nationally representative survey of caregivers conducted across the United States. The current study used data for youth 11-17 years old with a final sample size of 26,644. Hours of sleep, physical activity, and media use per day were dichotomized based on national recommendation guidelines for each health behavior (i.e., either meeting or not meeting guidelines). The OW/OB prevalence rate was 7% greater among unmedicated youth with ADHD than among medicated youth with ADHD. Medicated youth with ADHD and peers without ADHD had similar OW/OB rates. Among medicated youth with ADHD, physical activity, sleep duration, and media use did not contribute to OW/OB risk after controlling for family poverty level. However, among unmedicated youth with ADHD, meeting sleep duration guidelines was linked to a lower OW/OB risk. Overall, findings suggest that clinical providers and parents may wish to prioritize improved sleep duration in the management of OW/OB risk in youth with ADHD.

Mediation of Psychological Capital in Youth Experiencing Homelessness.

Youth who experience homelessness engage in behaviors that place them at high risk for disease and injury. Despite their health risk behaviors, these youth display psychological capital, positive attributes of hope, efficacy, resilience, and optimism that motivate them to engage in health-promoting behaviors such as safer sex. However, this array of positive psychological attributes has not been studied in this vulnerable population. The specific aim of this analysis was to determine whether factors of psychological capital mediated the relationship between background risk factors (e.g., race/ethnicity, educational attainment, reason for being homeless, sexual abuse history, and HIV status) and outcomes of condom intention, safer sex behaviors, and life satisfaction among youth who participated in a longitudinal intervention study. Using a Solomon four-group design, 602 youth were recruited from drop-in centers in two large cities (Columbus, Ohio, and Austin, Texas) to participate in a brief intervention that included outcomes of enhanced communication skills, goal setting, safer sex behaviors, drug refusal skills, and life satisfaction. Using an autoregressive, cross-lagged, longitudinal mediation model, we tested the direct and indirect effects of background factors, psychological capital, and intervention outcomes. Models were tested for the intervention group alone and the total sample. There were no significant direct or indirect effects of background factors on intervention outcomes among the intervention group, and the model fit was poor. There were also no significant mediating paths via factors of psychological capital and poor model fit for the combined group. Findings provide important information about intrinsic strengths of youth experiencing homelessness and psychological capital as a significant construct for understanding health behaviors among disadvantaged and underserved youth. The lack of significant mediation effects may have been due, in part, to the lack of a robust measure of psychological capital. Further study with various background factors and outcomes would contribute further to our understanding of how best to support this population.

Understanding Medication Nonadherence in Crohn's Disease Patients: A Qualitative Evaluation.

Immune-modifying medications are widely available and recognized as valuable by most gastroenterologists. However, approximately 40% of patients with Crohn's disease (CD) do not comply with regimens using these medications, resulting in complications, hospitalization, and surgeries. We sought to identify factors that motivate adherence or nonadherence with medication recommendations for CD. We conducted qualitative interviews with patients living with CD who were identified as adherent or nonadherent to immune-modifying medication recommendations by their treating gastroenterologist. Semistructured interview guides were developed based on an established framework for understanding health behaviors. We conducted content analysis of the resulting qualitative data using an inductive-deductive approach to identify emergent themes that influence medication decision-making. Twenty-five patients with CD completed interviews for this study. Interviews were independently coded and analyzed for thematic content. Two broad domains emerged comprising (1) themes reflected in the Theoretical Domains Framework and (2) novel themes specific to medication decision-making in CD. Adherent patients conveyed a sense of trust in science and healthcare provider expertise, while nonadherent patients were more likely to express beliefs in their ability to self-manage CD, concern about risks associated with medication, and a general ambivalence to treatment. There are clear cognitive, behavioral, and relational factors that guide patients' medication-related decision-making. Several of the factors share features of other behavioral change and decision-making processes, while others are specific to the experience of patients with CD. A fuller understanding of these factors is essential to developing effective behavioral interventions to improve adherence to evidence-based treatment recommendations.

Interrelatedness of women's health-behaviour cognitions: A dyadic study of female family members on carrying heavy loads during pregnancy in Nepal.

Decisions about reproductive health are often influenced by women's female family members, particularly in low-resource contexts. However, previous research has focused primarily on individual behavioural determinants. We investigated the interrelatedness of female family members' reproductive health behaviour with a dyadic version of an extended health action process approach. We investigated this for carrying heavy loads during pregnancy and postpartum, a risk factor for reproductive health in many low-income countries such as Nepal. This cross-sectional study included dyads of daughters-in-law and mothers-in-law in rural Nepal (N = 476, nested in 238 dyads). Dyads of daughters- and mothers-in-law were surveyed about avoiding carrying heavy loads during pregnancy and postpartum. The effects of a woman's cognitions and her female dyadic partner's cognitions on their intention and behaviour about avoiding carrying loads were estimated using linear mixed models. The results showed that a mother-in-law's cognitions were related to her daughter-in-law's intentions and vice versa. The mother-in-law's cognitions were also related to the daughter-in-law's behaviour. The mother-in-law's self-efficacy and injunctive norms related to the daughter-in-law's intention and behaviour over and above the daughter-in-law's own self-efficacy and injunctive norms. Female Nepali family members' cognitions about carrying heavy loads during pregnancy and postpartum are interrelated. Including female family members in interventions to help women manage their reproductive health in low-resource populations seems promising. These novel findings add to the growing body of research indicating the importance of including a dyadic perspective when understanding and changing health behaviour.

Results from Lung Cancer Screening Outreach Utilizing a Mobile CT Scanner in an Urban Area

IntroductionLung cancer screening using low-dose (LD) CT reduces lung cancer–specific and all-cause mortality in high-risk individuals, although significant barriers to screening remain. We assessed the outreach of a mobile lung cancer screening program to increase screening accessibility and early detection of lung cancer. MethodsWe placed a mobile CT unit in a high-traffic area in New York City and offered free screening to all eligible patients. Characteristics of the mobile screening cohort were compared with those of our hospital-based screening cohort. ResultsBetween December 9, 2019, and January 30, 2020, a total of 216 patients underwent mobile LDCT screening. Compared with the hospital-based screening cohort, mobile screening participants were significantly more likely to be younger, be uninsured, and have lower smoking intensity and were less likely to meet 2013 US Preventive Services Task Force guidelines (but would meet their 2021 guidelines) and self-identify as White race and Hispanic ethnicity. Asian New Yorkers were substantially underrepresented in both hospital and mobile screening cohorts, compared with their level of representation in New York City. Two patients were diagnosed with lung cancer and were treated. Potentially clinically significant non–lung cancer findings were identified in 28.2%, most commonly moderate-severe coronary artery calcification and emphysema. ConclusionsMobile LDCT screening is useful and effective in detecting lung cancer and other significant findings and may engage a distinct high-risk patient demographic. Disproportionately low screening rates among certain high-risk populations highlight the imperative of implementing strategies aimed at understanding health behaviors and access barriers for diverse populations. Effective care-navigation services, facilitating high-quality care for all patients, are critical.

Understanding Health Behaviors, Weight Perceptions, and Body Appreciation of Young Adult Women Engaged in the Body Positivity Movement.

The body positivity movement on social media is thought to foster body appreciation, but pervasive societal concern persists about the body positivity movement and the body image, health behaviors, and "normalization of obesity" of young adult women. This study explored the relationship between engagement in the body positivity movement on social media and weight status, body appreciation, body dissatisfaction, and the health behaviors of intuitive eating and physical activity in young adult women (18-35years). Participants (N=521; ∼64% engaged in body positivity content on social media) were recruited using Qualtrics online panels for this cross-sectional survey during February 2021. Outcomes included weight status, weight consideration, weight perception, body appreciation, body dissatisfaction, physical activity, and intuitive eating. Logistic and linear regression models adjusted for age, race, ethnicity, education level, and household income were used to assess the association between engagement in the body positivity movement and specified outcomes. Engagement in body positivity content was associated with greater body dissatisfaction (β=2.33, t(519)=2.90 p=.017), body appreciation (β=0.26, t(519)=2.90 p=.004), and greater likelihood of reporting high amounts of physical activity (odds ratio=2.28; p<.05) relative to nonengaged peers; these associations remained significant after further adjustment for weight status. Body positivity was not associated with weight status, weight perception, or intuitive eating. Engagement in the body positivity movement is associated with higher body dissatisfaction and body appreciation in young adult women, which suggests they may be drawn to and engage in the body positivity movement as a protective or coping mechanism for body dissatisfaction.

The AHAWOMEN project: study protocol of a multi-design research for exploring HAPA predictors of exercise in postmenopausal women

BackgroundThe postmenopausal period can represent an opportunity for women to improve their health and well-being. The Active and Healthy Ageing in Women during early postmenopause (AHAWOMEN) study aims to identify the key determinants of an active lifestyle among middle-aged women, with a focus on the stages and the social-cognitive variables outlined in the Health Action Process Approach (HAPA) model, a theoretical framework for understanding health behaviour change. We expected that HAPA factors and processes of intention creation (motivational phase) and action adoption (volitional phase) will be significant predictors of exercise initiation and maintenance, supporting both the HAPA tenets and the efficacy of HAPA-based interventions.Methods/designThis study was approved by the authors’ Institutional Review Committee. Postmenopausal women aged between 45 and 65 years will voluntarily participate. The participants will be allocated to one of three groups: Intervention-Initiators (n = 100, random allocation), Control-Sedentary (n = 100, random allocation) or Control-Active (n = 100, non-random allocation). The intervention group will engage in a supervised exercise programme lasting at least 3 months, supplemented with a HAPA-based intervention for behaviour change. The sedentary control group will not receive any intervention to change their physical activity, while the active control group will consist of women who are already regularly adhering to an active lifestyle. Study variables will be measured at baseline and postintervention phases, as well as at 1, 3, 6 and 12-month follow-ups. The predictors of exercise behaviour in the different phases of the behavioural change process will be explored and compared within and between groups throughout the study. These analyses will help identify the factors that determine the adoption of a healthy active behaviour. Additionally, the effectiveness of the model and the intervention for changing active behaviour will be evaluated.DiscussionThis paper describes the rationale, development and methods used in the AHAWOMEN project. Supporting women who intend to become active can help them to translate their goals into sustainable action. Verifying that the HAPA predictions are applicable to postmenopausal women’s adoption of exercise would provide the basis for designing effective interventions for promoting healthy and active ageing that are also tailored to the experiences of middle-aged women.Trial registrationISRCTN16251361. Registration date: 01/06/2023 (retrospectively registered).

Understanding health behavior change by motivation and reward mechanisms: a review of the literature.

The global rise of lifestyle-related chronic diseases has engendered growing interest among various stakeholders including policymakers, scientists, healthcare professionals, and patients, regarding the effective management of health behavior change and the development of interventions that facilitate lifestyle modification. Consequently, a plethora of health behavior change theories has been developed with the intention of elucidating the mechanisms underlying health behavior change and identifying key domains that enhance the likelihood of successful outcomes. Until now, only few studies have taken into account neurobiological correlates underlying health behavior change processes. Recent progress in the neuroscience of motivation and reward systems has provided further insights into the relevance of such domains. The aim of this contribution is to review the latest explanations of health behavior change initiation and maintenance based on novel insights into motivation and reward mechanisms. Based on a systematic literature search in PubMed, PsycInfo, and Google Scholar, four articles were reviewed. As a result, a description of motivation and reward systems (approach/wanting = pleasure; aversion/avoiding = relief; assertion/non-wanting = quiescence) and their role in health behavior change processes is presented. Three central findings are discussed: (1) motivation and reward processes allow to distinguish between goal-oriented and stimulus-driven behavior, (2) approach motivation is the key driver of the individual process of behavior change until a new behavior is maintained and assertion motivation takes over, (3) behavior change techniques can be clustered based on motivation and reward processes according to their functional mechanisms into facilitating (= providing external resources), boosting (= strengthening internal reflective resources) and nudging (= activating internal affective resources). The strengths and limitations of these advances for intervention planning are highlighted and an agenda for testing the models as well as future research is proposed.

Cancer-related information behavior among Black and Hispanic populations in an NCI-designated comprehensive cancer center catchment

ObjectiveThis study aims to better understand health behaviors, particularly health information seeking, and how this impacts cancer care within underserved minority populations in a specific catchment area in Florida. MethodsWe conducted an analysis of survey data from a 2019 community health survey conducted by the Moffit Cancer Center (MCC). We utilized the Comprehensive Model of Information Seeking (CMIS) as a framework and performed structural equation modeling (SEM) and related statistical analyses. ResultsOur findings confirm that characteristics and demographics present a positive relationship to Online Health Information Seeking (OHIS). We also found that Utility had a negative significant relationship to OHIS. ConclusionsWe concluded that the CMIS is a useful framework for studying cancer-related information seeking, and that when properly executed in the confines of a study, can lend itself to in-depth statistical analyses as found in SEM. ImplicationsThe SEM revealed the CMIS to be promising with results in our analysis worthy of further investigation of cancer care and healthcare information access considering undeserved and minority populations. Practice ImplicationsModels such as the CMIS can be useful for understanding information seeking behaviors and to design information and communication interventions to improve access and health outcomes.

Work participation in adults with rare genetic diseases - a scoping review

BackgroundWork participation is a crucial aspect of health outcome and an important part of life for most people with rare genetic diseases. Despite that work participation is a social determinant of health and seems necessary for understanding health behaviours and quality of life, it is an under-researched and under-recognized aspect in many rare diseases. The objectives of this study was to map and describe existing research on work participation, identify research gaps, and point to research agendas in a selection of rare genetic diseases.MethodsA scoping review was performed by searching relevant literature in bibliographic databases and other sources. Studies addressing work participation in people with rare genetic diseases published in peer reviewed journals were assessed using EndNote and Rayyan. Data were mapped and extracted based on the research questions concerning the characteristics of the research.ResultsOf 19,867 search results, 571 articles were read in full text, and 141 satisfied the eligibility criteria covering 33 different rare genetic diseases; 7 were reviews and 134 primary research articles. In 21% of the articles the primary aim was to investigate work participation. The extent of studies varied between the different diseases. Two diseases had more than 20 articles, but most had only one or two articles. Cross-sectional quantitative studies were predominant, with few utilizing prospective or qualitative design. Nearly all articles (96%) reported information about work participation rate, and 45% also included information about factors associated with work participation and work disability. Due to differences in methodologies, cultures and respondents, comparison between and within diseases are difficult. Nevertheless, studies indicated that many people with different rare genetic diseases experience challenges related to work, closely associated to the symptoms of the disease.ConclusionWhile studies indicate high prevalence of work disability in many patients with rare diseases, the research is scarce and fragmented. More research is warranted. Information about the unique challenges of living with different rare diseases is crucial for health and welfare systems to better facilitate work participation. In addition, the changing nature of work in the digital age, may also open up new possibilities for people with rare genetic diseases and should be explored.

Unpacking the Lay Epidemiology of Cervical Cancer: A Focus Group Study on the Perceptions of Cervical Cancer and Its Prevention among Women Late for Screening in Norway.

Nonattendance for cervical cancer screening is often understood in terms of a lack of 'appropriate' or 'correct' knowledge about the risks and prevention of the disease. Few studies have explored how lay persons-the users themselves-interpret and contextualise scientific knowledge about cervical cancer. In this study, we address the following research question: How is the epidemiology of cervical cancer and its prevention discussed among women who are late for cervical cancer screening in Norway? We completed nine focus group interviews (FGIs) with 41 women who had postponed cervical screening. The analyses were both inductive and explorative, aiming to unpack the complexity of lay understandings of cervical cancer. Interactive associations expressed in the FGIs reflected multiple understandings of aetiology and risk factors, screening, and interpretations of responsibility for acquiring cervical cancer. The term 'candidacy' was employed to provide an enhanced understanding of lay reasoning about the explanations and predictions of cervical cancer, as reflected in the FGIs. Both interpretations of biomedical concepts and cultural values were used to negotiate acceptable and nuanced interpretations of candidacy for cervical cancer. Uncertainties about risk factors for acquiring cervical cancer was an important aspect of such negotiations. The study's findings provide an in-depth understanding of the contexts in which screening may be rendered less relevant or significant for maintaining health. Lay epidemiology should not be considered inappropriate knowledge but rather as a productive component when understanding health behaviours, such as screening attendance.

Can the capabilities, opportunities and motivations model predict health behavior 1 year later?

The capabilities (C), opportunities (O) and motivations (M) model of behavior (B) change (COM-B) is designed to capture the key features of numerous models of behavior change, but little is known about its predictive validity. The present study tests the predictive validity of COM-B prospectively in the domain of attending hearing screening. 6,000 adults, representative of the U.K. population (e.g., 52.6% women) who one year earlier had reported COM with respect to attending hearing screening, were contacted again to complete an online survey with respect to their actual attendance. Data were analyzed descriptively, and with logistic regression to examine the influence of sociodemographic variables and COM on attendance at hearing screening. Respondents reported being highly capable of attending hearing screening (Ms > 7.98 on a 0-10 scale), but much lower levels of automatic (M = 4.21 on a 0-10 scale) and reflective (M = 5.21 on a 0-10 scale) motivations. Logistic regression analyses showed that men and older people were more likely to have their hearing checked but that hearing difficulty was the dominant determinant of attending hearing screening. Controlling for these sociodemographic and clinical variables, opportunities and motivations (but not capabilities) were also significantly associated with behavior. The COM-B model was predictive of attending hearing screening over a one-year period, which potentially makes it valuable for understanding health behavior change. Interventions for improving uptake in hearing screening that goes beyond increasing knowledge and skills (capabilities) are required to increase attendance at hearing screening. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Formative Research on HPV Vaccine Acceptance among Health Workers, Teachers, Parents, and Social Influencers in Uzbekistan.

Human papillomavirus (HPV) vaccines effectively prevent cervical cancer, most of which results from undetected long-term HPV infection. HPV vaccine introduction is particularly sensitive and complicated given widespread misinformation and vaccination of young girls before their sexual debut. Research has examined HPV vaccine introduction in lower- and middle-income countries (LMICs), but almost no studies attend to HPV vaccine attitudes in central Asian countries. This article describes the results of a qualitative formative research study to develop an HPV vaccine introduction communication plan in Uzbekistan. Data collection and analysis were designed using the Capability, Opportunity, and Motivation for Behaviour change (COM-B) mode for understanding health behaviours. This research was carried out with health workers, parents, grandparents, teachers, and other social influencers in urban, semi-urban, and rural sites. Information was collected using focus group discussions (FGDs) and semi-structured in-depth interviews (IDIs), and data in the form of participants' words, statements, and ideas were thematically analysed to identify COM-B barriers and drivers for each target group's HPV vaccine-related behaviour. Represented through exemplary quotations, findings were used to inform the development of the HPV vaccine introduction communication plan. Capability findings indicated that participants understood cervical cancer was a national health issue, but HPV and HPV vaccine knowledge was limited among non-health professionals, some nurses, and rural health workers. Results on an opportunity for accepting the HPV vaccine showed most participants would do so if they had access to credible information on vaccine safety and evidence. Regarding motivation, all participant groups voiced concern about the potential effects on young girls' future fertility. Echoing global research, the study results highlighted that trust in health workers and the government as health-related information sources and collaboration among schools, municipalities, and polyclinics could support potential vaccine acceptance and uptake. Resource constraints precluded including vaccine target-aged girls in research and additional field sites. Participants represented diverse social and economic backgrounds reflective of the country context, and the communication plan developed using research insights contributed to the Ministry of Health (MoH) of the Republic of Uzbekistan HPV vaccine introduction efforts that saw high first dose uptake.

Network canvas: an open-source tool for capturing social and contact network data.

Social influence and contact networks are extremely important for understanding health behaviour and the spread of disease. Yet, most traditional software tools are not optimized to capture these data, making measurement of personal networks challenging. Our team developed Network Canvas to provide an end-to-end workflow with intuitive interfaces to enable researchers to design and conduct network interviews. Network Canvas consists of three applications (Architect, Interviewer and Server). All applications are written in JavaScript and run on Windows, macOS and Linux; Interviewer also runs on Android and iOS. Network Canvas substantially reduces the complexity and technical knowledge required to collect network data via three point-and-click applications. The tool has wide applicability for measuring contact and social influence networks in epidemiology. Network Canvas is open source and freely available [networkcanvas.com] under the GNU General Public License 3.

Information, Motivation, Behavioral Skills Model in Youth Newly Starting Antiretroviral Treatment.

An understanding of adherence among youth newly starting antiretroviral therapy (ART) is critical but understudied. The information-motivation-behavioral skills (IMB) model is often used to understand health behaviors, but has rarely been studied in youth with HIV. In a multi-site sample of 153 youth newly starting ART, structural equation modeling was utilized to test this model. The model was generally supported with information and behavioral skills directly related to the decision to adhere, while motivation was indirectly related through behavioral skills. Results suggest that interventions focusing on improving IMB constructs for medication adherence are important for preventing non-adherence in youth newly starting ART.