This paper aims to provide an in-depth understanding of the attractiveness of e-cigarettes for several different groups. For this purpose, perceptions of and reasons for e-cigarette use were ...systematically reviewed as reported by e-cigarette users, cigarette smokers, dual users, and non-users, among both adults and youth. MEDLINE
and Scopus were used to search for relevant articles, and references of included studies were also investigated. Two reviewers screened all titles and abstracts independently, blinded to authors and journal titles (Cohen's Kappa = 0.83), resulting in 72 eligible articles. Risk perceptions, perceived benefits, and reasons for e-cigarette use were categorized in themes and sub-themes. Risk perceptions included harmfulness in general, and specific health risks. Perceived benefits included improved taste and smell, and safety for bystanders. Reasons for use included (health) benefits, curiosity, smoking cessation, and friends using e-cigarettes. The findings highlight that there is a variety of perceptions and reasons mentioned by adult and youth e-cigarette users, cigarette smokers, dual users, and non-users. As such, this overview provides valuable information for scientists, public health professionals, behavior change experts, and regulators to improve future research, risk communication, and possibilities to effectively regulate e-cigarettes.
Increasing numbers of university students in Sudan are at risk of contracting HIV because of their engagement in condomless sex. A comprehensive and culturally accepted condom promotion program could ...potentially reduce this threat substantially. However, little is known about the sociocognitive determinants of condom use in this population: information that is required to develop such HIV prevention programs. Therefore, in August 2014, we conducted 30 semi-structured individual interviews with male and female students (both currently sexually active and nonactive) to explore determinants of condom use based on the I-Change model. Data were analyzed using Nvivo 10. The results suggest that barriers to condom use among university students include misconceptions about condom use, negative attitudes toward condom use, lack of social support, low self-efficacy to use condoms, and poor action planning. Sexual health promotion should, therefore, address these aspects to successfully promote condom use among sexually active students and subsequently reduce the risk of HIV transmission.
People living in low‐income multi‐problem households may benefit from participation in a community‐based health promotion program. Yet, low participation rates are often a problem. It is important to ...assess reasons for (not) participating to better tailor programs to the needs of this particular at‐risk group. Back2Balance is a health promotion program for low‐income multi‐problem households from Apeldoorn, the Netherlands. We performed qualitative interviews among participants (n = 16) and non‐participants (n = 12) of the program and asked them for their reasons for (not) participating in the program. Interview transcripts were thematically analysed using the Framework method. Participants indicated that reasons for participating encompassed intrapersonal motivators (e.g. to become healthier), interpersonal motivators (e.g. participating to get to know new people) and program level motivators (e.g. learning about a healthy lifestyle, and free or very low cost). Participants and non‐participants outlined the importance of intrapersonal barriers (e.g. physical health problems), interpersonal barriers (e.g. family circumstances) and program level barriers (e.g. logistic issues, and not understanding or knowing about some part of the program). Concluding, combining health promotion with social interaction motivated participants to participate in the Back2Balance program. Yet, both participants and non‐participants experienced many barriers for participation, some of which were related to their multi‐problem situation.
Sexual intimate partner violence (IPV) is a public health problem worldwide. Research regarding beliefs about perpetrating sexual IPV is, however, limited. This study investigated attitudes, social ...influence, and self-efficacy beliefs and intentions toward perpetrating sexual IPV among Grade 8 adolescents (M age = 13.73, SD = 1.04) in the Western Cape Province of South Africa. The study sample was taken from the baseline data of the Promoting sexual and reproductive health among adolescents in Southern and Eastern Africa (PREPARE) study, a cluster-randomized controlled trial. Young adolescents (N = 2,199), from 42 randomly selected high schools, participated in the study and answered a paper-and-pencil questionnaire. Multivariate ANOVA were conducted to assess differences in beliefs and intention toward perpetrating sexual IPV between boys and girls, and between perpetrators and nonperpetrators. Results showed that boys were more frequently perpetrators (11.3% vs. 3.2%) and victims (13.6% vs. 6.4%) of sexual IPV than girls. Boys’ attitudes toward perpetrating sexual IPV were more supportive than girls’. Boys perceived their social network to be more likely to think that putting pressure on a boyfriend or girlfriend to have sex is okay, and boys had a lower self-efficacy to refrain from pressuring a boyfriend or girlfriend to have sex compared with girls. Both boys and girls, who have perpetrated sexual IPV, had more tolerant attitude, social influence, and self-efficacy beliefs toward sexual IPV perpetration, compared with nonperpetrators. Intention not to perpetrate sexual IPV did not differ between boys and girls, or between perpetrators and nonperpetrators. Our findings suggest that interventions should address attitude and social influence beliefs regarding sexual IPV perpetration. More attention should be given to sexual IPV perpetration among boys. Given that sexual IPV victimization and perpetration are significantly linked, prevention of sexual IPV perpetration seems to be of utmost importance.
Young South Africans, especially women, are at high risk of HIV. We evaluated the effects of PREPARE, a multi-component, school-based HIV prevention intervention to delay sexual debut, increase ...condom use and decrease intimate partner violence (IPV) among young adolescents. We conducted a cluster RCT among Grade eights in 42 high schools. The intervention comprised education sessions, a school health service and a school sexual violence prevention programme. Participants completed questionnaires at baseline, 6 and 12 months. Regression was undertaken to provide ORs or coefficients adjusted for clustering. Of 6244 sampled adolescents, 55.3 % participated. At 12 months there were no differences between intervention and control arms in sexual risk behaviours. Participants in the intervention arm were less likely to report IPV victimisation (35.1 vs. 40.9 %; OR 0.77, 95 % CI 0.61–0.99; t(40) = 2.14) suggesting the intervention shaped intimate partnerships into safer ones, potentially lowering the risk for HIV.
ABSTRACT
BACKGROUND
Bullying behavior in schools can lead to psychosocial problems. School‐based interventions are important in raising student awareness, developing their skills and in planning to ...reduce bullying behavior.
METHODS
A randomized controlled trial, using a school‐based educational intervention to reduce verbal bullying, was conducted among grade 10 students in 16 urban and rural schools in KwaZulu‐Natal, South Africa in 2013. Baseline and postintervention questionnaires, developed using the Integrated Model for Behavior Change theoretical model, were used to assess changes in verbal bullying.
RESULTS
Postintervention there were reduced verbal bullying experiences. Improved social norms and awareness of verbal bullying were associated with reduced verbal bullying experiences and behavior. Although less likely to bully others verbally, girls were more likely to experience verbal bullying. Students with no living father were more likely to bully others verbally.
CONCLUSIONS
The study findings indicate that a school‐based intervention can positively impact on verbal bullying experiences and behavior.
Purpose:
To investigate the direct and indirect effects of sociodemographic/health factors on diet quality through practical nutrition knowledge (PNK) about how to compose a balanced meal.
Design:
A ...cross-sectional study using data from an online survey of the 10 000 Steps cohort (data collected November-December 2016).
Setting:
Australia.
Participants:
Adults (n = 8161). Response rate was 16.7%.
Measures:
Self-reported lifestyle, health, and sociodemographic characteristics, including diet quality and PNK.
Analysis:
The PROCESS macro for SPSS was used to conduct the mediation analyses.
Results:
Better diet quality was associated with being female, older, more highly educated, and having a lower body mass index. Mediation analysis showed that PNK significantly mediated the associations between sex (a*b = 0.54, 95% confidence interval CI = 0.39-0.70) and education (vocational education: a*b = 0.22, 95% CI = 0.12-0.35, university: a*b = 0.48, 95% CI = 0.35-0.64), and diet quality. Practical nutrition knowledge suppressed the association between age and diet quality (a*b = −0.03, 95% CI = −0.04 to −0.03).
Conclusion:
Variations in diet quality between sociodemographic groups were partially explained by differences in PNK, suggesting that focusing public health efforts on increasing this specific knowledge type might be promising.
Aims
To identify determinants of practice nurses' intention to implement a new smoking cessation intervention and to investigate the independent value of attitude and Rogers' innovation ...characteristics.
Background
While effective smoking cessation interventions exist, implementation is often suboptimal. No previous studies have disentangled the independent value of beliefs towards implementation and innovation characteristics in explaining implementation.
Design
A cross‐sectional descriptive study.
Methods
In 2010, 56 of 91 general practice nurses who participated in an intervention effectiveness trial completed an online questionnaire concerning demographics, patient population characteristics, attitude, innovation characteristics, self‐efficacy, perceived social influence and intention to implement the intervention in the future. Recruitment success during the trial was defined as the number of patients participating. To detect differences between intending and non‐intending practice nurses, independent sample t‐tests and Chi‐squared tests were conducted. Correlation coefficients were calculated to identify associations between potential determinants of intention. To identify significant determinants logistic hierarchical regression analyses were conducted.
Results
Innovation characteristics and attitude were both significantly associated with practice nurses' intention to implement. While recruitment success showed a significant positive association with intention, perceived patient support was only a significant determinant when including innovation characteristics or attitude.
Conclusion
To increase new interventions' implementation rates, it is most important to convince health professionals of its beneficial characteristics, to generate a positive attitude towards the intervention, to aid practice nurses in recruiting smoking patients and to increase perceived patient support.
Appealing product characteristics, such as flavors, may stimulate e-cigarette use. While switching to e-cigarettes may reduce harm for smokers, concerns exist about e-cigarette use among ...never-smokers. The role of flavors in the decision to switch to or refrain from vaping is unclear. This study used a bottom-up approach to investigate the relation between flavor preferences and individual factors related to vaping between various user groups. A cross-sectional survey was conducted among never-users (
= 407), smokers (
= 138), dual users (
= 122), and exclusive vapers (
= 61) in the Netherlands. Demographics, attractiveness of product characteristics, flavor preferences, and individual factors related to vaping (knowledge, trust, perceived susceptibility, attitude, social influence, deliberation, and intention) were assessed. The availability of different flavors was the most attractive characteristic of e-cigarettes. Dual users and exclusive vapers had most often used tobacco and menthol/mint flavors when they first started vaping. Compared to dual users, exclusive vapers currently used more fruit and sweet flavors. Never-users who were interested in trying an e-liquid flavor had more knowledge about and a more positive attitude towards e-cigarettes. Smokers who were interested in trying a flavor had a more positive attitude towards e-cigarettes and experienced the social influence towards not using e-cigarettes as less strong than those who did not want to try any flavor. Hence, individual factors related to vaping differed depending on whether never-users and smokers wanted to try an e-liquid flavor. This means that flavors may moderate differences found in individual factors related to vaping, or vice versa.
Understanding the key factors that influence smoking behavior, especially during adolescence, has a meaningful impact on public health. This study examined the impact of parent modelling, peer ...influence and peer selection on adolescent smoking behavior in two Portuguese cohorts followed for three years.
A questionnaire was delivered in classes and schools randomly selected, three times, one per year (cohort1: time1-7th, time2-8th, time3-9th; cohort2: time1-10th, time2-11th, time3-12th graders).
The sample included a total of 656 students (402 younger time1 Mage = 13.17, SD = 0.53, 63.7% girls; and 254 older time 1 Mage = 16.20, SD = 0.53, 65% girls).
Longitudinal data were examined through an autoregressive cross-lagged model (ARCL). The model explained 35% of the variance in smoking behavior at T3 for the global sample (4% for the younger and 58% for the older).
Over time, in both cohorts, the percentage of never smokers decreased sharply and the percentage of regular smokers increased rapidly. We observed that participants in the older cohort had higher chances of smoking if their parents smoked. Nevertheless, we did not find a parental modelling effect in the longitudinal model. Peer influence and peer selection influenced smoking behavior. However, peer selection influenced the youngest group, both processes influenced the middle age group, and only peer influence influenced the oldest. Best friend and friends had a stronger impact on the younger while friends and same grade students had a stronger impact on the older. Prevention programs should regard these differences of interpersonal influences through adolescent development and specific strategies for different age groups should be considered.
•A three years longitudinal study based in two Portuguese adolescent cohorts.•Parents' modelling effect on adolescent smoking behavior was not consistent.•Peer influence and peer selection had an impact on adolescent smoking behavior.•Peer influence and peer selection effects changed according to adolescent age.•A developmental approach is relevant to explain adolescent smoking behavior.