Health Behaviour Change

Tabacchi, G., Mammina, C., Paoli, A., Filingeri, D., Bianco, A., Palma, A. (2011) The relationship between physical activity/sedentary behaviours, preadolescent schoolchildren weight status and gender in an area of Southern Italy. Journal of Sports Medicine and Physical Fitness. 51 (Suppl.1 to No. 3): 57.

by Davide Filingeri

Promoting Health Behaviour Choices: Understanding patient challenges by undertaking a personal behaviour change task

by Karen Morgan

Co-authored with Doyle F, Hickey A,  Doherty E & McGee H.

Unhealthy behaviours such as poor diet, smoking and low physical inactivity contribute significantly to chronic... more Unhealthy behaviours such as poor diet, smoking and low physical inactivity contribute significantly to chronic disease. Our first year medical school project aims to increase student awareness of: the importance of these behaviours and their systematic measurement; recommended behaviour targets in health professional guidelines; challenges to achieving patient behaviour change; and psychological theories which aid behaviour change. Students are provided with evidence-based health behaviour guidelines for prevention of heart disease. Students select whichever behaviour they would personally like to achieve improvement in, systematically record behaviour for one week (baseline), and then try to implement (healthy) behaviour change for the next two weeks, using psychological theory as an aide. Students report their results and discuss outcomes reflecting on explanations for the success or otherwise of their behaviour attempts. A virtual learning environment (Moodle) ensures project engagement and completion during the relevant timeframes.
This assignment has been successfully completed by students over previous academic years. The use of deadlines for uploading sections of coursework to Moodle (e.g. baseline data) has increased the quality and completeness of the projects. Students learn to use standard instruments such as the Fagerstrom Test for Nicotine Dependence and also learn recommended professional guidelines on diet and physical activity at an early point in medical training. Also, self-reported health behaviours improved over the course of the assignment. This project allows students to test the difficulty of adhering to professional advice they themselves will give to future patients. The assignment combines knowledge (e.g. education on chronic conditions, on the role of behaviour change and on professional guidelines), skills (e.g. documenting behaviours, planning and implementing change) and attitudes (e.g. on understanding the difficulties encountered by individuals when making and sustaining recommended behaviour change). The novel use of a virtual learning environment ensures high participation.

Explicit Prejudice is Alive and Kicking! Graphic Anti-Smoking Warnings Increase Prejudice in Non-Smokers Towards Smokers

by Caroline Wood

Paper presented at the annual meeting of the ISPP 34th Annual Scientific Meeting, Bilgi University, Istanbul, Turkey, Jul 09, 2011
Co-authored with Dr. Masi Noor

Around the world, graphic warnings on tobacco packaging are used with the intention to raise smoker awareness of the... more Around the world, graphic warnings on tobacco packaging are used with the intention to raise smoker awareness of the adverse consequences of smoking. Regardless of the effectiveness of these campaigns, inevitably as public images they are likely to be seen by non-smokers as well as smokers. This current research employed an experimental methodology to examine the effects of graphic anti-smoking warnings on non-smokers’ attitudes towards smokers.
Results revealed that non-smokers expressed more negative attitudes towards smokers in terms of prejudice and victim blame after exposure to an anti-smoking warning compared to non-smokers shown a control image. Furthermore, the presence of the warning provoked more blame amongst non-smokers with high belief in a just world compared to non-smokers with low belief in a just world. Findings are discussed in relation to intergroup relations and implications for graphic anti-smoking campaign effectiveness.

The Psychology and Politics of Smoking: The Impact of Fear, Hypocrisy and Processing Mode on Intentions to Quit Smoking

by Caroline Wood

Paper presented at the annual meeting of the ISPP 33rd Annual Scientific Meeting, Mark Hopkins Hotel, San Francisco, California, USA, Jul 07, 2010
Co-authored with Dr. Masi Noor

Anti-Smoking Campaigns in the United Kingdom and across Europe have recently relied on Fear to motivate people to quit... more Anti-Smoking Campaigns in the United Kingdom and across Europe have recently relied on Fear to motivate people to quit smoking. These are most commonly conveyed to the general public via pictures showing the gruesome consequences of smoking, usually presented on the cigarette packet. The question that the present research addresses is whether these scare tactics are effective in encouraging smokers to change their smoking habits?
Two experiments (N=160, N=100) were conducted to examine the role of fear, both on its own and in interaction with how smokers process information and deal with hypocrisy-induced dissonance, on intentions to quit smoking. Despite the successful manipulation of these factors, results yielded little support for the effects of fear on smoking intentions, both cross-sectionally and longitudinally. In order to shed light on these results, qualitative data were collected from smokers that highlighted how and why smoking behaviour is maintained and also key characteristics which would ultimately replace it.
Overall results are discussed in terms of their political, psychological and financial implications for smoking campaigns.

Mediation Analysis in Psychosomatic Medicine Research

by Ginger Lockhart

Chore or priority? Barriers and facilitators affecting dilator use after pelvic radiotherapy for gynaecological cancer

by Carissa Bonner

Carissa Bonner, Kathryn Nattress, Caroline Anderson, Jonathan Carter, Chris Milross, Shannon Philp, Ilona Juraskova. Supportive Care in Cancer 2011; DOI: 10.1007/s00520-011-1337-z.

Purpose
Pelvic radiotherapy for gynaecological cancer often leads to damage of the vaginal mucosa, resulting in... more Purpose
Pelvic radiotherapy for gynaecological cancer often leads to damage of the vaginal mucosa, resulting in stenosis (obstruction by scar tissue). Stenosis has been associated with sexual dysfunction and can hinder medical examinations to detect recurrence. The use of vaginal dilators is frequently recommended to prevent or minimise stenosis, but women are reluctant to use these devices. The aim of this study was to explore the patient experience of dilator use and identify the barriers and facilitators affecting compliance with clinician recommendations.

Methods
Women were eligible for the study if they had undergone pelvic radiotherapy for gynaecological cancer up to 2 years ago and received a vaginal dilator as part of their post-treatment rehabilitation. Fifteen participants completed a semi-structured interview.

Results
Barriers to dilator use included: uncertainty about how/when to use dilators, viewing it as a negative experience, lack of time or forgetting and the need for discretion due to an association with sex aids. Facilitators included: concern about stenosis, belief that dilators work, reminders of stenosis, acceptance of dilator use as part of their normal routine or an extension of medical treatment and focusing on positive aspects. These factors were incorporated into a model of dilator use based on the Health Belief Model.

Conclusions
This is the first qualitative study to specifically investigate the patient experience of dilator use. The barriers and facilitators identified in this study and the proposed theory-based model provide new insights to inform future research and clinical management of dilator use.

The Effectiveness of Interventions to Change Six Health Behaviours: a Review of Reviews

by Fiona Harris

Exploring behavioural change through an agent-oriented System Dynamics model. The use of personal protective equipment among pesticide applicators in Colombia.

by Giuseppe Feola

with Gallati J.A. and Binder C.R., in the System Dynamics Review 28(1):68-93.

The misuse of Personal Protective Equipment results in health risk among smallholders in developing countries, and... more The misuse of Personal Protective Equipment results in health risk among smallholders in developing countries, and education is often proposed to promote safer practices. However, evidence point to limited effects of education. This paper presents a System Dynamics model which allows the identification of risk-minimizing policies for behavioural change. The model is based on the IAC framework and survey data. It represents farmers' decision-making from an agent-oriented standpoint. The most successful intervention strategy was the one which intervened in the long term, targeted key stocks in the systems and was diversified. However, the results suggest that, under these conditions, no policy is able to trigger a self sustaining behavioural change. Two implementation approaches were suggested by experts. One, based on constant social control, corresponds to a change of the current model's parameters. The other, based on participation, would lead farmers to new thinking, i.e. changes in their decision-making structure.

Why Don't Pesticide Applicators Protect Themselves?: Exploring the Use of Personal Protective Equipment Among Colombian Smallholders

by Giuseppe Feola

with C.R. Binder, International Journal of Occupational and Environmental Health, 16(1):11-23. Also available here: http://centaur.reading.ac.uk/23999/

The misuse of personal protective equipment (PPE) during pesticide application was investigated among smallholders in... more The misuse of personal protective equipment (PPE) during pesticide application was investigated among smallholders in Colombia. The integrative agent-centered (IAC) framework and a logistic regression approach were adopted. The results suggest that the descriptive social norm was significantly influencing PPE use. The following were also important: (1) having experienced pesticide-related health problems; (2) age; (3) the share of pesticide application carried out; and (4) the perception of PPE hindering work. Interestingly, the influence of these factors differed for different pieces of PPE. Since conformity to the social norm is a source of rigidity in the system, behavioral change may take the form of a discontinuous transition. In conclusion, five suggestions for triggering a transition towards more sustainable PPE use are formulated: (1) diversifying targets/tools; (2) addressing structural aspects; (3) sustaining interventions in the long-term; (4) targeting farmers’ learning-by-experience; and (5) targeting PPE use on a collective level.

How much behaviour change should we expect from health promotion campaigns targeting cognitions? An approach to pre-intervention assessment

by Chris Fife-Schaw

Author version availabe for download. this appeared as: Fife-Schaw, C.R. & Abraham, C, (2009). How much behaviour change should we expect from health promotion campaigns targeting theory-based cognitions? Psychology and Health, 24, 763-776.

For those planning interventions based on social cognition models it is usually not clear what impact on behaviour... more For those planning interventions based on social cognition models it is usually not clear what impact on behaviour will follow from attempts to change the cognitions specified in these models. We describe a statistical simulation technique to assess the likely impact of health promotion targeting Theory of Reasoned Action (TRA)-based predictors of condom use. We apply regression-based simulation techniques to data from the SHARE project (n = 756 Scottish adolescents) to assess the potential impact of changes in cognitions on condom use. Results support the predictive utility of TRA-based models of psychological antecedents of condom use but also provide a cautionary warning about the magnitude of behaviour change likely to be achieved by interventions based on such models.

Assessment Of Impact Of Education On Human Health Behavior In Jhansi, Uttar Pradesh, India

by Dr. Lavkush Dwivedi

Co-authored with Dr. Rambir Singh

Education is an important social determinant of health. Knowledge and skills (personal & social) achieved through... more Education is an important social determinant of health. Knowledge and skills (personal & social) achieved through it can better equip us to get benefitted from maximum health services and incentive programmes. It is a factor responsible to generate more cohesive, safer, healthier and wealthier society. Conversely, the lower level of education provide shelter to increased risk of durable illness and finally to die at younger age. Jhansi, a globally famed historical district of Bundelkhand is remaining a socio-economically backward area due to political negligence. The education level of the population is not very satisfactory. Therefore, a study was done in the present investigation to explore the health impact of education on the population of Jhansi. The health risk assessment questionnaire (HRAQ) based consented health survey of total 2000 individuals of stated area was done. As a result, the increased incidences of ill health behaviors (87%) were reported among uneducated volunteers while the educated respondents were found comparatively healthy (only 32% unhealthy cases). Interestingly, the number of educated volunteers (n=1419) was more than the uneducated ones (n=581).

Understanding the role of life events in weight loss and weight gain

by Jane Ogden

A study of general practitioners' reasons for changing their prescribing behaviour

by David Armstrong

Implementing evidence based medicine in general

by David Armstrong

Patients’ responses to risk information about the benefits of treating hypertension

by David Armstrong

Clinical autonomy, individual and collective: the problem of changing doctors' behaviour

by David Armstrong

The role of etiquette and experimentation in explaining how doctors change behaviour

by David Armstrong

Origins of the problem of health-related behaviours: a genealogical study

by David Armstrong

Thomas Tryon's Regimen for Women: Sectarian Health in the Seventeenth Century

by Ginnie Smith

Clean: a History of Personal Hygiene and Purity

by Ginnie Smith