Objectives
The physical activity (PA) intention–behaviour gap is a topic of considerable contemporary research, given that most of our models used to understand physical activity suggest that ...intention is the proximal antecedent of behavioural enactment. The purpose of this study was to quantify the intention–PA gap at public health guidelines with a meta‐analysis of the action control framework.
Design
Systematic review and meta‐analysis.
Methods
Literature searches were conducted in July 2012 among five key search engines. This search yielded a total of 2,865 potentially relevant records; of these, 10 studies fulfilled the full eligibility criteria (N = 3,899).
Results
Random‐effects meta‐analysis procedures with correction for sampling bias were employed in the analysis for estimates of non‐intenders who subsequently did not engage in physical activity (21%), non‐intenders who subsequently performed physical activity (2%), intenders who were not successful at following through with their PA (36%), and successful intenders (42%). The overall intention–PA gap was 46%.
Conclusion
These results emphasize the weakness in early intention models for understanding PA and suggest this would be a problem during intervention. Contemporary research that is validating and exploring additional constructs (e.g., self‐regulation, automaticity) that augment intention or improving the measurement of motivation seems warranted.
Statement of contribution
What is already known on this subject? Intention is considered the proximal antecedent of behaviour in many popular models. Intention is also an established correlate of physical activity behaviour, yet discordance is considerable in experimental research.
What does this study add? This meta‐analysis of studies that have assessed concordance/discordance of physical activity intention and behaviour at public health guidelines shows the intention–behaviour gap at 48% and the discordance is from intenders who do not act. The results demonstrate that discordance is not just from extreme levels of intention or behaviour (e.g., intend to exercise six times but only exercise five), but from levels that are relevant to health promotion.
Background
Health behaviour models typically neglect habitual action. The Self-Report Habit Index (SRHI) permits synthesis of evidence of the influence of habit on behaviour.
Purpose
The purpose of ...this study is to review evidence around mean habit strength, habit–behaviour correlations, and habit × intention interactions, from applications of the SRHI to dietary, physical activity, and active travel behaviour.
Method
Electronic database searches identified 126 potentially relevant papers. Twenty-two papers (21 datasets) passed eligibility screening. Mean scores and correlations were meta-analysed using fixed, random and mixed effects, and interactions were synthesised via narrative review.
Results
Twenty-three habit–behaviour correlations and nine habit × intention interaction tests were found. Typical habit strength was located around the SRHI midpoint. Weighted habit–behaviour effects were medium-to-strong (fixed:
r
+
= 0.44; random:
r
+
= 0.46). Eight tests found that habit moderated the intention–behaviour relation.
Conclusion
More comprehensive understanding of nutrition and activity behaviours will be achieved by accounting for habitual responses to contextual cues.
The twelve-item Self-Report Habit Index (SRHI) is the most popular measure of energy-balance related habits. This measure characterises habit by automatic activation, behavioural frequency, and ...relevance to self-identity. Previous empirical research suggests that the SRHI may be abbreviated with no losses in reliability or predictive utility. Drawing on recent theorising suggesting that automaticity is the 'active ingredient' of habit-behaviour relationships, we tested whether an automaticity-specific SRHI subscale could capture habit-based behaviour patterns in self-report data.
A content validity task was undertaken to identify a subset of automaticity indicators within the SRHI. The reliability, convergent validity and predictive validity of the automaticity item subset was subsequently tested in secondary analyses of all previous SRHI applications, identified via systematic review, and in primary analyses of four raw datasets relating to energy-balance relevant behaviours (inactive travel, active travel, snacking, and alcohol consumption).
A four-item automaticity subscale (the 'Self-Report Behavioural Automaticity Index'; 'SRBAI') was found to be reliable and sensitive to two hypothesised effects of habit on behaviour: a habit-behaviour correlation, and a moderating effect of habit on the intention-behaviour relationship.
The SRBAI offers a parsimonious measure that adequately captures habitual behaviour patterns. The SRBAI may be of particular utility in predicting future behaviour and in studies tracking habit formation or disruption.
Objectives. Repeated action can lead to the formation of habits and identification as ‘the kind of person’ that performs the behaviour. This has led to the suggestion that identity‐relevance is a ...facet of habit. This study explores conceptual overlap between habit and identity, and examines where the two constructs fit into an extended Theory of Planned Behaviour (TPB) model of binge‐drinking among university students.
Design. Prospective, questionnaire‐based correlational design.
Methods. A total of 167 UK university students completed baseline measures of past behaviour, self‐identity, the Self‐Report Habit Index (SRHI), and TPB constructs. One week later, 128 participants completed a follow‐up behaviour measure.
Results. Factor analyses of the SRHI and four identity items revealed two correlated but distinct factors, relating to habit and identity, respectively. Hierarchical regression analyses of intention and behaviour showed that identity contributed over and above TPB constructs to the prediction of intention, whereas habit predicted behaviour directly, and interacted with intentions in predicting behaviour. Habits unexpectedly strengthened the intention–behaviour relation, such that strong intenders were more likely to binge‐drink where they also had strong habits.
Conclusions. Identity and habit are conceptually discrete and impact differently on binge‐drinking. Findings have implications for habit theory and measurement. Recommendations for student alcohol consumption reduction initiatives are offered.
Most research on web-based help seeking for mental health problems has focused on the antecedents of this behavior. Therefore, little is known about the outcomes of web-based help seeking in general ...or in specific mental health issues.
This study was a systematic review and meta-analysis of the literature on the antecedents and consequences of web-based help-seeking behaviors for depressive symptoms.
A systematic literature search was carried out in 6 scientific databases, leading to 48 studies (for a total of 314,921 participants) included in the qualitative synthesis and 19 included in the meta-analysis.
The results indicated a positive relationship between depressive symptoms and web-based help-seeking behaviors through online support groups (r=0.089; P=.009), and Generation Z (r=0.102; P=.008) tended to participate in support groups more than previous generations. In addition, web-based help seeking was positively related to empowerment (r=0.245; P=.004). Other forms of support reported included the internet and specific self-help tools, but no significant relationships were found with depressive symptoms.
More studies examining the outcomes are needed, together with a more rigorous assessment of web-based help-seeking behaviors. Ultimately, we propose a summary framework for the literature on this topic, including the antecedents, patterns of use, and outcomes of web-based help seeking in the context of depressive symptoms.
Abstract
Background
The proliferation of health misinformation on social media is a growing public health concern. Online communities for mental health (OCMHs) are also considered an outlet for ...exposure to misinformation. This study explored the impact of the self-reported volume of exposure to mental health misinformation in misinformation agreement and the moderating effects of depression literacy and type of OCMHs participation (expert vs. peer-led).
Methods
Participants (n = 403) were recruited in Italian-speaking OCMHs on Facebook. We conducted regression analyses using PROCESS macro (moderated moderation, Model 3). Measures included: the Depression Literacy Questionnaire (Griffiths et al., 2004), the self-reported misinformation exposure in the OCMHs (3 items), and misinformation agreement with the exposure items (3 items). Whether participants were members of expert or peer-led OCMHs was also investigated.
Results
The final model explained the 12% variance in the agreement. There was a positive and significant relationship between misinformation exposure and misinformation agreement (β = 0.3221, p < .001), a significant two-way interaction between misinformation exposure and depression literacy (β = − 0.2179, p = .0014 ), and between self-reported misinformation exposure and type of OCMH (β = − 0.2322, p = .0254), such that at higher levels of depression literacy and in case of participation to expert-led OCMHs, the relationship misinformation exposure-misinformation agreement was weaker. Finally, a three-way interaction was found (β = 0.2497, p = .0144) that showed that depression literacy moderated the positive relationship between misinformation exposure and misinformation agreement such that the more misinformation participants were exposed to, the more they agreed with it unless they had higher levels of depression literacy; this, however, occurred only if they participated in peer-led groups.
Conclusions
Results provide evidence that the more members reported being exposed to mental health misinformation, the more they tended to agree with it, however this was only visible when participants had lower depression literacy and were participating in peer-led OCMHs. Results of this study suggest that both internal factors (i.e., high depression literacy) and external factors (the type of online community individuals were participating in) can buffer the negative effects of misinformation exposure. It also suggests that increasing depression literacy and expert community moderation could curb the negative consequences of misinformation exposure related to mental health. Results will guide interventions to mitigate the effects of misinformation in OCMHs, including encouraging health professionals in their administration and implementing health education programs.
Background
Asthma exacerbations are frequently induced by respiratory tract infections (RTIs). Bacterial lysates have been described to possess immune‐modulatory effects and reduce RTIs as well as ...asthma symptoms in children. However, whether bacterial lysates have similar effects in adult asthma patients is unknown.
Aims
To reduce asthma exacerbations by add‐on bacterial lysate therapy in adults with severe asthma and to characterize the clinical and immune‐modulatory effects of this treatment.
Methods
Asthma patients (GINA 4) with ≥2 annual exacerbations in the previous year were included. The intervention regimen consisted of OM‐85/placebo for 10 consecutive days per month for 6 months during two winter seasons. Primary end‐point was the number of severe asthma exacerbations within 18 months. The study was approved by the national and local ethical review board and registered in the Dutch Trial Registry (NL5752). All participants provided written informed consent.
Results
Seventy‐five participants were included (38 OM‐85; 37 placebo). Exacerbation frequencies were not different between the groups after 18 months (incidence rate ratio 1.07, 95%CI 0.68–1.69, p = 0.77). With the use of OM‐85, FEV1% increased by 3.81% (p = 0.04) compared with placebo. Nasopharyngeal swabs taken during RTIs detected a virus less frequently in patients using OM‐85 compared to placebo (30.5% vs. 48.0%, p = 0.02).
In subjects with type 2 inflammation adherent to the protocol (22 OM‐85; 20 placebo), a non‐statistically significant decrease in exacerbations in the OM‐85 group was observed (IRR = 0.71, 95%CI 0.39–1.26, p = 0.25). Immune‐modulatory effects included an increase in several plasma cytokines in the OM‐85 group, especially IL‐10 and interferons. Peripheral blood T‐ and B cell subtyping, including regulatory T cells, did not show differences between the groups.
Conclusion
Although OM‐85 may have immune‐modulatory effects, it did not reduce asthma exacerbations in this heterogeneous severe adult asthma group. Post hoc analysis showed a potential clinical benefit in patients with type 2 inflammation.
Seventy‐five severe asthma patients were included (38 OM‐85; 37 placebo). While intention to treat (ITT) analysis revealed no difference in exacerbation frequencies between the groups after 18 months, per protocol analysis in patients with type 2 inflammation (PPT2) showed a non‐significant decrease. Nasopharyngeal swabs detected a virus less frequently in the OM‐85 group during respiratory tract infections. Immune‐modulatory effects were seen in several plasma cytokines. To conclude, OM‐85 might be an effective add‐on therapy in severe asthma patients with type 2 inflammation.
Mental health problems are recognized as a pressing public health issue, and an increasing number of individuals are turning to online communities for mental health to search for information and ...support. Although these virtual platforms have the potential to provide emotional support and access to anecdotal experiences, they can also present users with large amounts of potentially inaccurate information. Despite the importance of this issue, limited research has been conducted, especially on the differences that might emerge due to the type of content moderation of online communities: peer-led or expert-led. We aim to fill this gap by examining the prevalence, the communicative context, and the persistence of mental health misinformation on Facebook online communities for mental health, with a focus on understanding the mechanisms that enable effective correction of inaccurate information and differences between expert-led and peer-led groups. We conducted a content analysis of 1534 statements (from 144 threads) in 2 Italian-speaking Facebook groups. The study found that an alarming number of comments (26.1%) contained medically inaccurate information. Furthermore, nearly 60% of the threads presented at least one misinformation statement without any correction attempt. Moderators were more likely to correct misinformation than members; however, they were not immune to posting content containing misinformation, which was an unexpected finding. Discussions about aspects of treatment (including side effects or treatment interruption) significantly increased the probability of encountering misinformation. Additionally, the study found that misinformation produced in the comments of a thread, rather than as the first post, had a lower probability of being corrected, particularly in peer-led communities. The high prevalence of misinformation in online communities, particularly when left uncorrected, underscores the importance of conducting additional research to identify effective mechanisms to prevent its spread. This is especially important given the study’s finding that misinformation tends to be more prevalent around specific “loci” of discussion that, once identified, can serve as a starting point to develop strategies for preventing and correcting misinformation within them.
Antimicrobial resistance is a major global health threat. Therefore, promising new antibacterial technologies that could minimize our dependence on antibiotics should be widely adopted. This study ...aims to identify the barriers and facilitators of the adoption of new antibacterial technologies in hospital patient care.
Semi-structured interviews, based on the Consolidated Framework for Implementation Research, were conducted with healthcare professionals related to the orthopedics department of an academic hospital in The Netherlands.
In total, 11 healthcare professionals were interviewed. Scientific evidence for the effectiveness of the technology was the most explicitly mentioned facilitator of adoption, but other (often contextual) factors were also considered to be important. At the level of the inner and outer setting, high costs and lacking coverage, competition from other firms, and problems with ordering and availability were the most explicit perceived barriers to adoption. Participants did not collectively feel the need for new antibacterial technologies.
Barriers and facilitators of the adoption of new antibacterial technologies were identified related to the technology, the hospital, and external factors. The implementation climate might have an indirect influence on adoption. New antibacterial technologies that are scientifically proven effective, affordable, and easily obtainable will most likely be adopted.
Good dental hygiene is key to public health. To promote dental hygiene behaviours, persuasive messages are key. Message framing is a popular theory that has seen mixed evidence. In this web-based ...experimental study, interaction effects of message frame, behavioural function, and risk priming were investigated on mouth rinse use and intentions in a representative sample of Dutch adults. Final included sample contained 549 participants (50.1% male, mean age = 47.4, SD = 16.1) and outcomes were immediate mouth rinse product choice, intentions to use mouth rinse, and mouth rinse behaviour at 2-week follow-up. Results demonstrated a theorized significant interaction between message frame and behavioural function were mouth rinse product choice. Two-week follow-up mouth rinse behaviour was affected by an interaction between message frame and risk prime. Message framing can thus be employed to promote dental health, but it requires attention to moderation effects which are inconsistent across behavioural outcomes.
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