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Expanding the value of qualitative theories of illness experience in clinical practice: a grounded theory of secondary heart disease prevention
Ononeze, V., Murphy, A.W., MacFarlane, A., Byrne, M., Bradley, C. Thu, 14 May 2009 00:00:00 -0000
Qualitative theories of illness experience are about the individual interpretations of the psychosocial and cultural aspects of living with illness. Thus, they contribute to a better understanding of health and health care provision. In this paper, we examine how a grounded theory (GT) of heart disease experience can inform secondary prevention. In-depth interviews of individual experience of heart disease were conducted with 26 patients, using GT iterative data collection and analysis framework. A GT was compiled from data and examined within a sociocultural framework to ascertain how experience influenced health behaviour. Despite individual contextual variations, the theory of ‘keeping it going’ describes the study sample’s common attitude to living with heart disease. The theory was adequate in explaining secondary cardiac behaviour, because it identified the aspects of patients’ beliefs and attitudes which are key to effective secondary prevention. The assessment of the impact of illness experience on health behaviour within a sociocultural framework helped to articulate the strong influence of social and contextual factors. The study offers an appropriate explanatory framework for encouraging health behaviour change. It emphasizes the importance of interventions being relevant to individual perceptions and interpretations. It provides a framework for designing and evaluating cardiac interventions and the theoretical principles which underpin them.
Effects of episodic variations in web-based avian influenza education: influence of fear and humor on perception, comprehension, retention and behavior
Kim, P., Sorcar, P., Um, S., Chung, H., Lee, Y. S. Thu, 14 May 2009 00:00:00 -0000
In order to provide empirical evidence on the role of a web-based avian influenza (AI) education program for mass communication and also ultimately help young children learn and develop healthy behaviors against AI and all types of influenza, an education program with two episodic variations (i.e. fear and humor) has been developed and examined with 183 fifth-grade elementary students. A quasi-experimental design was employed to find potential differential effects on the context-specific risk perception, AI knowledge acquisition, retention and behavior. The study results reveal that the fear appealed AI web-based education program was much more effective than the humor-based program in improving risk perception and educating the students about healthy behaviors (i.e. against influenza infection). However, a significant behavior change or improvement of health practices was not apparent on the post-tests (i.e. 1 month after the treatment) in either episode of the program.
Developing the IDEFICS community-based intervention program to enhance eating behaviors in 2- to 8-year-old children: findings from focus groups with children and parents
Haerens, L., De Bourdeaudhuij, I., Barba, G., Eiben, G., Fernandez, J., Hebestreit, A., Kovacs, E., Lasn, H., Regber, S., Shiakou, M., De Henauw, S., on behalf of the IDEFICS consortium Thu, 14 May 2009 00:00:00 -0000
One purpose of ‘identification and prevention of dietary- and lifestyle-induced health effects in children and infants’ (IDEFICS) is to implement a standardized community-based multi-component healthy eating intervention for younger children in eight different countries. The present study describes important influencing factors for dietary behaviors among children aged 2–8 years old in order to determine the best approaches for developing the dietary components of the standardized intervention. Twenty focus groups with children (74 boys, 81 girls) and 36 focus groups with 189 parents (28 men, 161 women) were conducted. Only in two countries, children mentioned receiving nutrition education at school. Rules at home and at school ranged from not allowing the consumption of unhealthy products to allowing everything. The same diversity was found for availability of (un)healthy products at home and school. Parents mentioned personal (lack of time, financial constraints, preferences), socio-environmental (family, peer influences), institutional (school policies) and physical–environmental (availability of unhealthy products, price, season) barriers for healthy eating. This focus group research provided valuable information to guide the first phase in the IDEFICS intervention development. There was a large variability in findings within countries. Interventions should be tailored at the personal and environmental level to increase the likelihood of behavioral change.
Implementation fidelity: the experience of the Adolescent Substance Abuse Prevention Study
Sloboda, Z., Stephens, P., Pyakuryal, A., Teasdale, B., Stephens, R. C., Hawthorne, R. D., Marquette, J., Williams, J. E. Thu, 14 May 2009 00:00:00 -0000
While researchers have developed more effective programs and strategies to prevent the initiation of substance use and increasingly communities are delivering these interventions, determining the degree to which they are delivered as they were designed remains a significant research challenge. In the past several years, more attention has been given to implementation issues during the various stages of program development and diffusion. This paper presents the findings from a substudy of an evaluation of a newly designed middle and high school substance abuse prevention program, Take Charge of Your Life delivered by local Drug Abuse Resistance Education officer instructors. A key aspect of the study was to determine the extent to which implementation fidelity, using the measures of content coverage and appropriate instructional strategy, was associated with improvement in the program mediators of realistic normative beliefs, understanding the harmful effects of substance use and the acquisition of decision-making and resistance skills. Although it was found that higher fidelity was associated with better scores on some of the mediators, this was not a consistent finding. The mixed results are discussed within the context of the lesson activities themselves.
'Ready. Set. ACTION!' A theater-based obesity prevention program for children: a feasibility study
Neumark-Sztainer, D., Haines, J., Robinson-O'Brien, R., Hannan, P. J., Robins, M., Morris, B., Petrich, C. A. Thu, 14 May 2009 00:00:00 -0000
This study examined the feasibility of implementing an innovative theater-based after-school program, ‘Ready. Set. ACTION!’, to reach ethnically diverse and low-income children and their parents with obesity prevention messages. The study population included 96 children and 61 parents. Children were in fourth to sixth grade and 41% were overweight at baseline. Program impact was evaluated with a pre/post-randomized controlled study design, but a major focus was placed on the process evaluation conducted in the intervention schools. Intervention children and parents reported high program satisfaction and that they had made changes or intended to make positive changes in their behaviors due to program participation. However, few meaningful differences between the intervention and control conditions were found at follow-up. Thus, the combined process and impact evaluation results suggest that the intervention was effective in leading to increased awareness of the need for behavioral change, but was not powerful enough on its own to lead to behavioral change. From this feasibility study, we concluded that Ready. Set. ACTION! offers promise as a creative intervention strategy. The next research step may be to incorporate theater-based programs into more comprehensive school-based interventions, with both educational and environmental components, and evaluate program impact.
There's alcohol in my soap: portrayal and effects of alcohol use in a popular television series
van Hoof, J. J., de Jong, M. D. T., Fennis, B. M., Gosselt, J. F. Thu, 14 May 2009 00:00:00 -0000
Two studies are reported addressing the media influences on adolescents’ alcohol-related attitudes and behaviours. A content analysis was conducted to investigate the prevalence of alcohol portrayal in a Dutch soap series. The coding scheme covered the alcohol consumption per soap character, drinking situations and drinking times. Inter-coder reliability was satisfactory. The results showed that alcohol portrayal was prominent and that many instances of alcohol use reflected undesirable behaviours. To assess the influence of such alcohol cues on adolescents, a 2 x 2 experiment was conducted focusing on the separate and combined effects of alcohol portrayal in the soap series and surrounding alcohol commercials. Whereas the alcohol commercials had the expected effects on adolescents’ attitudes, the alcohol-related soap content only appeared to have unexpected effects. Adolescents who were exposed to the alcohol portrayal in the soap series had a less positive attitude towards alcohol and lower drinking intentions. Implications of these findings for health policy and future research are discussed.

 
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