? All interventions
We conducted two Facebook experiments (the first one during July 21–25, 2016, and the second during April 22–25, 2018) to determine what type of message related to injunctive norms is more effective in getting Hispanic women interested in learning about financial planning for retirement. We also explore how social media tools could be used in future interventions to promote retirement saving among Hispanic women. In both experiments, we found that a message centered on peer influence may be more successful than a message centered on familism in getting Hispanic women interested in learning more about financial planning for retirement. When we disaggregate our data by age and state, we find that click-through rates were higher among Hispanic women between 45 and 55 years old, and the largest numbers of impressions were among Hispanic women in California and Texas. When we disaggregate our data by device, we find that most study participants were reached through an Android smartphone.
| C Ploem, ES Byers|
Journal of psychology & human sexuality [9:1-24] (1997)
An intervention combining AIDS information with condom eroticization, condom normalization, and communication skills training was found to increase both AIDS-related knowledge and condom use among Canadian college students. 112 unmarried female undergraduates (mean age, 18 years) were randomly assigned to this combination intervention (n = 49), an information-only intervention (n = 44), or a pre-test/post-test control group (n = 19). 80% of students had engaged in vaginal intercourse and 14% in anal intercourse. 84% of coitally active women had engaged in unprotected intercourse in the past year and 48% had not used condoms consistently with any sexual partner. Condom use in the pre-intervention period was associated with positive attitudes toward the method and the perception that condom use was normative among peers. One month after the interventions, both the combination and information groups, but not controls, showed an increase over baseline in AIDS-related knowledge. However, among the 36 students who were coitally active in the 1-month periods before and after the intervention, only the combination intervention was associated with increased condom use. In the combination group, the percentage of episodes of intercourse protected by condoms increased from an average of 21.8% in the month preceding the study to 50% during the 4-week follow-up period. Due to the small sample size and design of the study, it was not possible to determine which component of the multifaceted educational intervention was most responsible for this change.
| Jeanne Marrazzo, Katherine Thomas, Kathleen Ringwood|
Sexually transmitted infections [87:399-405] (2011)
Bacterial vaginosis (BV) is common in lesbians, and treatment fails in up to 28%. Risks include sexual behaviours that transmit vaginal fluid. The authors measured efficacy of a behavioural intervention to reduce sexual transfer of vaginal fluid between female sex partners in reducing BV persistence.
Women aged 16-35 years with BV who reported sex with women (prior year) were eligible. Participants were randomised to intervention (motivational interviewing designed to reduce sharing of vaginal fluid on hands or sex toys post-treatment, by provision of condoms, gloves and water-based lubricant) or control (general STI education) arms. All were treated with vaginal metronidazole and underwent computer-assisted self-interview to ascertain sexual behaviours, with test-of-cure at 30 days.
Of 129 women with BV, 108 (84%) were eligible; 89 (69%) agreed to enrol. 43 were randomised to control and 46 to intervention; 81 (91%) returned for test-of-cure. BV persisted in 12 (27.9%) of 43 women in intervention and 8 (21.1%) of 38 women in control arms (p1/40.6). Digital-vaginal sex was common post-treatment (50% intervention and 68% control); women randomised to the intervention were less likely to report receptive digital-vaginal sex without gloves than control (31% vs 61%; p1/40.01), without reported lower frequency of other sexual practices. Shared vaginal use of sex toys was infrequent.
Although the intervention effected a significant increase in glove use during digital-vaginal sex post-BV treatment, this was not associated with reduction in BV persistence. Shared use of vaginal sex toys was infrequent, suggesting that other mechanisms promote BV in lesbians.
| Susan Tross, Aimee NC Campbell, Lisa Cohen, Donald Calsyn, Martina Pavlicova, Gloria Miele, Mei-Chen Hu, Louise Haynes, Nancy Nugent, Weijin Gan, Mary Hatch-Maillette, Raul Mandler, Paul McLaughlin, Nabila El-Bassel, Paul Crits-Christoph, Edward Nunes|
Journal of acquired immune deficiency syndromes (1999) [48:581-9] (2008)
Because drug-involved women are among the fastest growing groups with AIDS, sexual risk reduction intervention for them is a public health imperative.
To test effectiveness of HIV/STD safer sex skills building (SSB) groups for women in community drug treatment.
Randomized trial of SSB versus standard HIV/STD Education (HE); assessments at baseline, 3 and 6 months.
Women recruited from 12 methadone or psychosocial treatment programs in Clinical Trials Network of National Institute on Drug Abuse. Five hundred fifteen women with >or=1 unprotected vaginal or anal sex occasion (USO) with a male partner in the past 6 months were randomized.
In SSB, five 90-minute groups used problem solving and skills rehearsal to increase HIV/STD risk awareness, condom use, and partner negotiation skills. In HE, one 60-minute group covered HIV/STD disease, testing, treatment, and prevention information.
Number of USOs at follow-up.
A significant difference in mean USOs was obtained between SSB and HE over time (F = 67.2, P < 0.0001). At 3 months, significant decrements were observed in both conditions. At 6 months, SSB maintained the decrease and HE returned to baseline (P < 0.0377). Women in SSB had 29% fewer USOs than those in HE.
Skills building interventions can produce ongoing sexual risk reduction in women in community drug treatment.
| Maria Testa, Joseph Hoffman, Jennifer Livingston, Rob Turrisi|
Prevention science : the official journal of the Society for Prevention Research [11:308-18] (2010)
A randomized controlled trial, using parent-based intervention (PBI) was designed to reduce the incidence of alcohol-involved sexual victimization among first-year college students. The PBI, adapted from Turrisi et al. (2001), was designed to increase alcohol-specific and general communication between mother and daughter. Female graduating high school seniors and their mothers were recruited from the community and randomly assigned to one of four conditions: Alcohol PBI (n = 305), Enhanced Alcohol + Sex PBI (n = 218), Control (n = 288) or Unmeasured Control (n = 167). Mothers in the intervention conditions were provided an informational handbook and encouraged to discuss its contents with their daughters prior to college matriculation. Consistent with hypotheses, PBI, either standard or enhanced, was associated with lower incidence of incapacitated rape in the first year of college relative to controls. Path analysis revealed support for a hypothesized indirect effects model, by which intervention increased mother-daughter communication, which predicted lower frequency of first semester heavy episodic drinking, resulting in lower rates of alcohol-involved sexual victimization in the first year of college.
| Kylie Ball, Sarah McNaughton, Nd Le Ha, Gavin Abbott, Lena Stephens, David Crawford|
The American journal of clinical nutrition (2016)
Behavioral interventions show potential for promoting increased fruit and vegetable consumption in the general population. However, little is known about their effectiveness or cost-effectiveness among socioeconomically disadvantaged groups, who are less likely to consume adequate fruit and vegetables.
This study investigated the effects and costs of a behavior change intervention for increasing fruit and vegetable purchasing and consumption among socioeconomically disadvantaged women.
ShopSmart 4 Health was a randomized controlled trial involving a 3-mo retrospective baseline data collection phase [time (T) 0], a 6-mo intervention (T1-T2), and a 6-mo no-intervention follow-up (T3). Socioeconomically disadvantaged women who were primary household shoppers in Melbourne, Australia, were randomly assigned to either a behavior change intervention arm (n = 124) or a control arm (n = 124). Supermarket transaction (sales) data and surveys measured the main outcomes: fruit and vegetable purchases and self-reported fruit and vegetable consumption.
An analysis of supermarket transaction data showed no significant intervention effects on vegetable or fruit purchasing at T2 or T3. Participants in the behavior change intervention arm reported consumption of significantly more vegetables during the intervention (T2) than did controls, with smaller intervention effects sustained at 6 mo postintervention (T3). Relative to controls, vegetable consumption increased by ∼0.5 serving · participant(-1) · d(-1) from baseline to T2 and remained 0.28 servings/d higher than baseline at T3 among those who received the intervention. There was no intervention effect on reported fruit consumption. The behavior change intervention cost A$3.10 (in Australian dollars) · increased serving of vegetables(-1) · d(-1)Conclusions: This behavioral intervention increased vegetable consumption among socioeconomically disadvantaged women. However, the lack of observed effects on fruit consumption and on both fruit and vegetable purchasing at intervention stores suggests that further investigation of effective nutrition promotion approaches for this key target group is required. The ShopSmart 4 Health trial was registered at www.isrctn.com as ISRCTN48771770.
| Marilia Cornélio, Gaston Godin, Roberta Rodrigues, Rúbia Agondi, Thaís Spana, Maria-Cecilia Gallani|
European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology [12:385-92] (2013)
Despite strong evidence for a relationship between high salt intake and hypertension, plus the widespread recommendations for dietary salt restriction among hypertensive subjects, there are no nursing studies describing effective theory-based interventions.
To describe a systematic process for development of a theory-based nursing intervention that is aimed at reducing salt intake among hypertensive women, by applying the 'intervention mapping' protocol.
We developed our intervention following the six steps of the 'intervention mapping' protocol: assessing needs, creating a matrix of change objectives, selecting theoretical methods and practical applications, defining the intervention programme, organizing the adoption and implementation plan, and defining the evaluation plan.
Addition of salt during cooking is identified as the main source for salt consumption, plus women are identified as the people responsible for cooking meals at home. In our study, the motivational predictors of this behaviour were self-efficacy and habit. Guided practice, verbal persuasion, coping barriers, consciousness-raising and counter-conditioning were the theoretical methods we selected for enhancing self-efficacy and promoting habit change, respectively. Brainstorming, role-playing, cookbook use, measuring spoon use, label reading, hands-on skill-building activities and reinforcement phone calls were the chosen practical applications. We designed our intervention programme, and then organized the adoption and implementation plans. Finally, we generated a plan to evaluate our intervention.
'Intervention mapping' was a feasible methodological framework to guide the development of a theory-based nursing intervention for dietary salt reduction among hypertensive women.
| Debbie Smith, Wendy Taylor, Melissa Whitworth, Stephen Roberts, Colin Sibley, Tina Lavender|
Midwifery [31:280-7] (2015)
maternal obesity [body mass index (BMI)≥30kg/m(2)] is a cause for concern because of increasing rates and risk of associated complications. However, little is known about how to improve the health of women with a BMI≥30kg/m(2).
a 10-week antenatal lifestyle programme (The Lifestyle Course - TLC), underpinned by behaviour change theory, was developed in a programme of research which included a prospective, multicentred, feasibility phase (n=227). Participants had a BMI≥30kg/m(2) at the start of their pregnancy, planned to deliver in two areas of Greater Manchester and were aged 18 or over. The objectives were to (1) assess the feasibility of the intervention and (2) to pilot the trial processes and outcome measures.
(1) Trial intervention: only 22% of women in the feasibility phase had received gestational weight advice prior to the study. One or more TLC sessions were attended by 79% of women and 97% said they would recommend TLC to a friend due to the content suitability, perceived personal gains and extra care received. Changes to the TLC were suggested and implemented in the pilot phase. (2) Trial processes: recruitment rates (36%), retention rates (100%) and questionnaire completion rates up to one year (33%) were found. Daily general 'lifestyle' diaries and pedometers were not acceptable data collection tools (response rates of 32% and 16% respectively). However, specific food diaries were acceptable (response rates of 80-81%). The major challenge was the collection of maternal weight data at the follow-up points.
the antenatal intervention (TLC) designed for this programme of work appears to suit the needs of women with a BMI≥30kg/m(2). The need for an antenatal intervention is clear from this study and also highlights reflections on effective communication with pregnant women with a BMI≥30kg/m(2). Lessons learnt for designing a future trial include effective ways to communicate with pregnant women with a BMI≥30kg/m(2).
| Marci Campbell, Irene Tessaro, Brenda DeVellis, Salli Benedict, Kristine Kelsey, Leigh Belton, Antonio Sanhueza|
Preventive medicine [34:313-23] (2002)
This study assessed the effects of the Health Works for Women (HWW) intervention on improving multiple behaviors including nutrition and physical activity among rural female blue-collar employees in North Carolina.
Nine small to mid-size workplaces were randomly assigned to either intervention or delayed intervention conditions. After a baseline survey, an intervention consisting of two computer-tailored magazines and a natural helpers program was conducted over 18 months. Delayed worksites received one tailored magazine. Approximately 77 and 76% of baseline respondents completed follow-up surveys at 6 and 18 months, respectively, and 538 women (63%) completed all three surveys.
At the 18-month follow-up, the intervention group had increased fruit and vegetable consumption by 0.7 daily servings compared to no change in the delayed group (P < 0.05). Significant differences in fat intake were observed at 6 months (P < 0.05) but not at 18 months. The intervention group also demonstrated improvements in strengthening and flexibility exercise compared to the delayed group. The rates of smoking cessation and cancer screening did not differ between study groups.
The HWW project was a successful model for achieving certain health behavior changes among blue-collar women.
| Robert Carels, Lynn Darby, Holly Cacciapaglia, Olivia Douglass|
Journal of women's health (2002) [13:412-26] (2004)
The impact of a 6-month lifestyle change intervention on cardiovascular risk factors in obese, sedentary, postmenopausal women was examined. A secondary aim of this investigation was to determine whether the addition of self-control skills training to an empirically supported lifestyle change intervention would result in greater cardiovascular risk reduction.
Forty-four women were randomly assigned to receive either a lifestyle change or a lifestyle change with self-control skills intervention. Pretreatment and posttreatment weight loss, body composition, physical activity, cardiorespiratory fitness, diet, blood pressure (BP), blood lipids, and psychosocial functioning were assessed. Also, at 1-year posttreatment, weight loss, body composition, self-reported physical activity, and psychosocial functioning were assessed.
The women significantly increased their physical activity (+39.6%) and cardiorespiratory fitness (+13.5%) and reduced their body weight (-6.5%), fat mass (-7.4%), body fat (-2.4%), BP (SBP -6.2%, DBP -9.2%), total cholesterol (-7.4%), triglycerides (-16.5%), and low-density lipoprotein (LDL) cholesterol (9.1%) and improved their diet (p < 0.05). At the 1-year follow-up, women had regained approximately 63% of their posttreatment weight loss (p < 0.05), but had maintained their previous increases in physical activity. Additionally, there were no significant changes in fat free mass, body fat, anxiety, or depression between the end of treatment and 1-year posttreatment. The addition of self-control skills training did not significantly improve cardiovascular risk reduction.
Lifestyle change interventions may be an effective means for reducing cardiovascular risk in obese, sedentary, postmenopausal women. However, greater attention should be devoted to the maintenance of these positive lifestyle changes.
| Mary Barker, Janis Baird, Wendy Lawrence, Megan Jarman, Christina Black, Katharine Barnard, Sue Cradock, Jenny Davies, Barrie Margetts, Hazel Inskip, Cyrus Cooper|
Journal of health psychology [16:178-91] (2011)
The Southampton Initiative for Health is a training intervention with Sure Start Children's Centre staff designed to improve the diets and physical activity levels of women of childbearing age. Training aims to help staff to support women in making changes to their lifestyles by improving three skills: reflection on current practice; asking 'open discovery' questions; and goal-setting. The impact of the training on staff practice is being assessed. A before and after non-randomized controlled trial is being used to evaluate the effectiveness and cost-effectiveness of the intervention in improving women's diets and increasing their physical activity levels.
| Mary Dinger, Kristiann Heesch, Kristi McClary|
American journal of health promotion : AJHP [20:2-6] ()
To examine the impact of a 6-week minimal contact intervention on walking behavior, the 10 processes of change of the transtheoretical model (TTM), and self-efficacy among insufficiently active women.
This study used a pre-experimental design. Of the 43 women who began the study, 36 (84%) completed questionnaires at baseline and postintervention. They were given brochures and pedometers and were sent e-mails that contained messages designed to positively affect TTM constructs. Changes in time spent walking, use of the 10 processes of change, and self-efficacy were analyzed using Wilcoxon signed rank tests and paired t-tests.
Participants significantly increased their total walking minutes (p = .001) and use of counterconditioning, dramatic relief reinforcement management, self-liberation, stimulus control, and social liberation (p < .05).
The findings of this feasibility study provide preliminary evidence that this theoretically based, minimal contact lifestyle intervention may be an effective, low-cost approach to increase walking among insufficiently active women.
| C Costanzo, SN Walker|
Women & health [47:91-108] (2008)
To compare the efficacy of five versus one session of Behavioral Counseling in a 12-week intervention to increase self-efficacy and family and friend support for activity, and examine self-efficacy and support as mediators of activity among 46 urban women.
A randomized, controlled trial conducted during 2004 in Omaha, Nebraska. Outcomes were analyzed with Repeated Measures-ANOVA and path analysis.
No significant change was observed in self-efficacy in the five-session group, but a significant decrease was observed in the one-session group (p = .005). Family and friend support increased significantly in the five-session group (p < .001, p = .019). The intervention effect on activity was mediated through change in self-efficacy and family support.
Five behavioral counseling sessions maintained self-efficacy and increased family and friend support although the intervention did not directly affect activity.
The intervention can be replicated within various community settings.
| Lorraine Walker, Jeanne Freeland-Graves, Tracey Milani, Goldy George, Henry Hanss-Nuss, Minseong Kim, Bobbie Sue Sterling, Gayle Timmerman, Susan Wilkinson, Kristopher Arheart, Alexa Stuifbergen|
Women & health [40:19-34] (2004)
This paper presents a longitudinal analysis of behavioral and psychosocial correlates of weight trends during the first postpartum year. Data are derived from the Austin New Mothers Study (ANMS), a longitudinal study of a low-income, tri-ethnic sample of postpartum women that incorporated serial assessment of weight and behavioral and psychosocial variables.
Postpartum body mass index (BMI) was measured prospectively (post-delivery, 6 weeks, and 3, 6, and 12 months postpartum). The analytic sample consisted of 382 White, African American, and Hispanic women receiving maternity care funded by Medicaid who had at least three measured postpartum weights. Behavioral and psychosocial variables included energy intakes, fat intakes, physical activity, health related lifestyle, smoking, breastfeeding, contraception, depressive symptoms, emotional eating, body image, and weight-related distress.
Using hierarchical linear modeling to incorporate baseline only and time-varying effects, significant associations with postpartum BMI were found for the following variables: ethnicity (p = .001), time of weight measurement (p < .001), the interaction of ethnicity and time (p = .005), pre-pregnant BMI (p < .001), gestational weight gain (p < .001), weight-related distress (p < .001), and energy intakes (p = .005). After adjusting for covariates, ethnic groups displayed differing trends in postpartum BMI resulting in White women having significantly lower BMIs at 12 months postpartum compared to ethnic minority women (p's < .01).
Behavioral and psychosocial variables contribute to a fuller understanding of BMI status of low-income women during the first postpartum year.
| Debra Anderson, Khadegh Mizzari, Victoria Kain, Joan Webster|
Health care for women international [27:238-53] (2006)
The purpose of this study was to test the efficacy of a multimodal intervention (Women's Wellness Program) to improve women's cardiovascular risk factors. This 12-week randomized experiment with a control group targeted women 50-65 years living in the general population. Women in the intervention group were provided with a consultation with a registered nurse at which time biophysical cardiovascular risk measures were taken and health education was provided in both verbal and written form. Women were encouraged to review their smoking, nutrition, and water intakes and to commence an exercise program that included aerobic fitness exercises. Women in the control group continued their normal activities. The sample consisted of 90 women aged 50-65 years. Pre- and post-intervention assessment utilized seven measures of cardiovascular risk factors: waist-to-hip ratio (WHR), body mass index (BMI), blood pressure, heart rate, weight, exercise levels, and smoking. Analysis of covariance indicated that the intervention was effective in improving women's aerobic exercise activity and decreasing smoking. The data from all five biophysical outcome measures supported the efficacy of the intervention, with significant decreases seen in the women's WHR, BMI, blood pressure, and measured weight. Study implications suggest that this type of intervention may provide an effective, clinically manageable therapy for women who prefer a self-directed approach to preventing and decreasing cardiovascular risk factors.
| Cindy Perry, Anne Rosenfeld, Jill Bennett, Kathleen Potempa|
The Journal of cardiovascular nursing [22:304-12] ()
Walking can significantly increase cardiorespiratory fitness and thereby reduce the incidence of heart disease in women. However, there is a paucity of research aimed at increasing walking in rural women, a high-risk group for heart disease and one for which exercise strategies may pose particular challenges.
This study tested Heart-to-Heart (HTH), a 12-week walking program, designed to increase fitness through walking in rural women. Heart-to-Heart integrated individual-oriented strategies, including motivational interviewing, and group-based strategies, including team building.
Forty-six rural women were randomized to either HTH or a comparison group. The primary outcome of cardiorespiratory fitness and secondary outcomes of self-efficacy and social support were measured preintervention and post-intervention. Group differences were analyzed with repeated-measures analysis of variance.
Women in HTH group had a greater improvement in cardiorespiratory fitness (P =.057) and in social support (P =.004) compared with women in the comparison group. Neither group of women experienced a change in exercise self-efficacy (P =.814).
HTH was effective in improving cardiorespiratory fitness in a sample of rural women. Further research is needed to refine HTH and determine the optimal approach in rural women to increase their walking.
| KP Arbour, Ginis Martin|
Psychology & health [24:49-65] (2009)
The combination of low physical activity rates and increased cardiovascular deaths indicate the overwhelming need for behaviour change interventions that can effectively promote physical activity among sedentary women. This 11-week randomised controlled trial examined the effects of an implementation intentions intervention on sedentary women's walking behaviour. Seventy-five women (M age = 48.17) were randomly assigned to either a control group where they were required to self-monitor their daily pedometer-determined step count or to an experimental group where they were asked to form specific walking plans (i.e. implementation intentions) every 6 weeks and to self-monitor their daily pedometer-determined step count. Measures of exercise intentions, perceived behavioural control, scheduling and barrier self-efficacy were administered at baseline, week 6 and week 11. Analyses indicated higher step counts over the first 6 weeks for women in the experimental condition (p < 0.02). Furthermore, higher self-efficacy to schedule (p < 0.01) and overcome walking barriers (p < 0.03), as well as higher perceptions of behavioural control (p < 0.02) were found at week 11 for women in the experimental versus control condition. However, none of the control beliefs were found to mediate the effects of the intervention on the women's walking behaviour. Furthermore, the intervention did not have any effect on the strength of the goal intention-behaviour relationship. The findings suggest implementation intentions are an effective strategy for initiating leisure-time walking within sedentary women.
| Karen Joy Anderson, Carol Pullen|
Research in gerontological nursing [6:11-21] (2013)
A cluster randomized study was conducted using a convenience sample of four Christian faith communities from which 27 African American women 60 and older were recruited. The purpose was to determine whether African American women receiving a physical activity intervention with spiritual strategies compared to a control group would demonstrate differences over time in physical activity behaviors and biomarkers, in self-efficacy for physical activity, and in barriers to physical activity. Results with baseline and 12-week measurements included significant between-group findings at 12 weeks on muscle strength activity (minutes per week, z = -3.269, p = 0.001; days per week, z = -3.384, p = 0.001), favoring the intervention group. There were significant between-group findings in 6-minute walk change scores (z = -2.546, p = 0.009), favoring the intervention group. Barriers were significantly reduced within the intervention group (z = -2.184, p = 0.029). Evidence suggests a physical activity intervention with spiritual strategies increases physical activity behavior. The Health Promotion Model can be used to develop physical activity interventions with spiritual strategies for older African American women in faith communities, thus, supporting Healthy People 2020 goals.
| Jane Anthony Peterson, Bernice Yates, Jan Atwood, Melody Hertzog|
Western journal of nursing research [27:93-110] (2005)
Physical activity is associated with health and reduced mortality risk, yet only 15% of U.S. adults achieve adequate activity. This study is an experimental repeated measures nested design randomizing two similar rural communities to investigate the effectiveness of the Heart and Soul Physical Activity Program (HSPAP) (Peterson, 2002) in promoting physical activity in midlife women (n=42) aged 35 to 65 years. The HSPAP, an innovative church-based health promotion intervention, is conceptualized in social support and designed to increase physical activity, energy expenditure (EE), and cardiorespiratory fitness (VO2 max), measured over time. A significant interaction (p<.001) was found for EE in one HSPAP group increasing their EE by 1,010 kcals/week. HSPAP participants increased their VO2 max level by 75% (p<.001) and 10%; comparison groups stayed the same or declined 16%. Study results provide preliminary support for the HSPAP intervention as an effective treatment to improve physical activity levels in sedentary, rural, midlife women.
| Ya-Jung Wang, Marcia Boehmke, Yow-Wu Wu, Suzanne Dickerson, Nadine Fisher|
Cancer nursing [34:E1-13] ()
In Western culture, evidence has shown that in women with breast cancer exercise decreases fatigue and improves quality of life. However, only 1 pilot study about the effect of exercise has been examined in the Asian breast cancer population that indicated feasibility. Therefore, it is important to further study the effect of an exercise program for Taiwanese women with breast cancer.
The purpose of this study was to test the effects of a walking program on Taiwanese women newly diagnosed with early-stage breast cancer.
This was an experimental, longitudinal study with 4-time repeated measures based on Bandura's Self-efficacy Theory, with the aim of implementing interventions to boost exercise self-efficacy and to evaluate research outcomes. SPSS 17.0 with descriptive statistics using frequency, percentage, mean, and SD as well as inferential statistics such as t test, χ test, hierarchical linear model, repeated-measures analysis of variance, and analysis of covariance was used for data analysis.
Results of this study indicated that subjects in the exercise group had significantly better quality of life, less fatigue, less sleep disturbances, higher exercise self-efficacy, more exercise behavior, and better exercise capacity compared with those in the usual-care group after the intervention.
This program was effective and feasible, but more research studies with experimental, longitudinal design to verify the effects of this exercise program on Taiwanese women with breast cancer will be needed.
Nurses, depending on skill and knowledge, can encourage physical activity, refer patients to rehabilitation programs, and prescribe and monitor exercise in breast cancer population.
| Gillian Gould, Yael Bar-Zeev, Michelle Bovill, Lou Atkins, Maree Gruppetta, Marilyn Clarke, Billie Bonevski|
Implementation science : IS [12:114] (2017)
Indigenous smoking rates are up to 80% among pregnant women: prevalence among pregnant Australian Indigenous women was 45% in 2014, contributing significantly to the health gap for Indigenous Australians. We aimed to develop an implementation intervention to improve smoking cessation care (SCC) for pregnant Indigenous smokers, an outcome to be achieved by training health providers at Aboriginal Medical Services (AMS) in a culturally competent approach, developed collaboratively with AMS.
The Behaviour Change Wheel (BCW), incorporating the COM-B model (capability, opportunity and motivation for behavioural interventions), provided a framework for the development of the Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy implementation intervention at provider and patient levels. We identified evidence-practice gaps through (i) systematic literature reviews, (ii) a national survey of clinicians and (iii) a qualitative study of smoking and quitting with Aboriginal mothers. We followed the three stages recommended in Michie et al.'s "Behaviour Change Wheel" guide.
Targets identified for health provider behaviour change included the following: capability (psychological capability, knowledge and skills) by training clinicians in pharmacotherapy to assist women to quit; motivation (optimism) by presenting evidence of effectiveness, and positive testimonials from patients and clinicians; and opportunity (environmental context and resources) by promoting a whole-of-service approach and structuring consultations using a flipchart and prompts. Education and training were selected as the main intervention functions. For health providers, the delivery mode was webinar, to accommodate time and location constraints, bringing the training to the services; for patients, face-to-face consultations were supported by a booklet embedded with videos to improve patients' capability, opportunity and motivation.
The ICAN QUIT in Pregnancy was an intervention to train health providers at Aboriginal Medical Services in how to implement culturally competent evidence-based practice including counselling and nicotine replacement therapy for pregnant patients who smoke. The BCW aided in scientifically and systematically informing this targeted implementation intervention based on the identified gaps in SCC by health providers. Multiple factors impact at systemic, provider, community and individual levels. This process was therefore important for defining the design and intervention components, prior to a conducting a pilot feasibility trial, then leading on to a full clinical trial.
| Hein De Vries, Martijntje Bakker, Patricia Dolan Mullen, Gerard van Breukelen|
Patient education and counseling [63:177-87] (2006)
Smoking during pregnancy is an important problem in the Netherlands. We tested the effectiveness of a health counseling method by midwives using a RCT.
Four provinces with 42 practices including 118 midwives were randomly assigned to the experimental or control condition. Midwives in the experimental group provided brief health counseling, self-help materials on smoking cessation during pregnancy and early postpartum, and a partner booklet. Controls received routine care. The main outcome measures were 7-day abstinence, continuous abstinence, and partner smoking at 6 weeks post-intervention (T1) and 6 weeks postpartum (T2).
Multi-level analysis revealed significant differences between both conditions at T1 and T2 using intention-to-treat analysis. Nineteen percent of the experimental group reported 7-day abstinence compared to 7% of the control group at T1, and 21 and 12%, respectively, at T2. For continuous abstinence these percentages were 12% in the experimental group and 3% in the control group. The partner intervention was not successful.
The intervention resulted in significant effects on smoking behavior for pregnant women, but not for partner smoking.
The program realized short-term effects. An important precondition is that midwives need a proper training.
| L Aiken, S West, C Woodward, R Reno, K Reynolds|
Health psychology : official journal of the Division of Health Psychology, American Psychological Association [13:526-38] (1994)
Two theory-based programs to increase mammography screening rates among asymptomatic women were implemented and evaluated in the community. One program (E) was based on the Health Belief Model (HBM); the second program (EP) added exercises adapted from the social psychology of compliance. Program impact on screening among 295 primarily Caucasian, middle-class women was evaluated against untreated controls (C) over a 6-month period. Both programs led to increases in HBM components (Perceived Susceptibility, and Perceived Benefits) and Intentions to obtain a mammogram. Screening rates 2 to 3 times higher were observed in the EP and E over C conditions; EP and E did not differ. A mediational model of compliance illustrated the interplay of HBM components in the compliance process.
| R Alcalay, A Ghee, S Scrimshaw|
Public health reports (Washington, D.C. : 1974) [108:354-62] ()
Communication theories and research data were used to design cross-cultural health education messages. A University of California Los Angeles-Universidad Autonoma in Tijuana, Mexico, research team used the methods of ethnographic and survey research to study behaviors, attitudes, and knowledge concerning prenatal care of a sample of pregnant low-income women living in Tijuana. This audience provided information that served as a framework for a series of messages to increase awareness and change prenatal care behaviors. The message design process was guided by persuasion theories that included Petty and Caccioppo's elaboration likelihood model, McGuire's persuasion matrix, and Bandura's social learning theory. The results from the research showed that poor women in Tijuana tend to delay or not seek prenatal care. They were not aware of symptoms that could warn of pregnancy complications. Their responses also revealed pregnant women's culturally specific beliefs and behaviors regarding pregnancy. After examination of these and other results from the study, prenatal care messages about four topics were identified as the most relevant to communicate to this audience: health services use, the mother's weight gain, nutrition and anemia, and symptoms of high-risk complications during pregnancy. A poster, a calendar, a brochure, and two radio songs were produced and pretested in focus groups with low-income women in Tijuana. Each medium included one or more messages addressing informational, attitudinal, or behavioral needs, or all three, of the target population.
| John Jemmott, Alisa Stephens-Shields, Ann O'Leary, Loretta Sweet Jemmott, Anne Teitelman, Zolani Ngwane, Xoliswa Mtose|
Preventive medicine [72:1-7] (2015)
Increasing physical activity is an important public-health goal worldwide, but there are few published mediation analyses of physical-activity interventions in low-to-middle-income countries like South Africa undergoing a health transition involving markedly increased mortality from non-communicable diseases. This article reports secondary analyses on the mediation of a theory-of-planned-behavior-based behavioral intervention that increased self-reported physical activity in a trial with 1181 men in Eastern Cape Province, South Africa.
Twenty-two matched-pairs of neighborhoods were randomly selected. Within pairs, neighborhoods were randomized to a health-promotion intervention or an attention-matched control intervention with baseline, immediate-post, and 6- and 12-month post-intervention assessments. Theory-of-planned-behavior constructs measured immediately post-intervention were tested as potential mediators of the primary outcome, self-reported physical activity averaged over the 6- and 12-month post-intervention assessments, using a product-of-coefficients approach in a generalized-estimating-equations framework. Data were collected in 2007-2010.
Attitude, subjective norm, self-efficacy, and intention were significant mediators of intervention-induced increases in self-reported physical activity. The descriptive norm, not affected by the intervention, was not a mediator, but predicted increased self-reported physical activity.
The results suggest that interventions targeting theory-of-planned-behavior constructs may contribute to efforts to increase physical activity to reduce the burden of non-communicable diseases among South African men.
A randomized evaluation found that clients who were offered commitment savings accounts saved an extra 235 pesos over the first six months of the program, and an extra 411 pesos during the first year.
| Jennifer Sallit, Michele Ciccazzo, Zisca Dixon|
Journal of the American Dietetic Association [109:1398-405] (2009)
Many people use smoking as a weight control mechanism and are averse to quitting for fear of weight gain. These weight-concerned smokers tend to be women, are significantly less likely to stop smoking or to join smoking cessation programs, and will relapse more often than smokers who are not weight-concerned. Research suggests that a woman's motivation to quit smoking correlates positively with her confidence in her ability to control her weight after quitting. Likewise, success in smoking cessation has been associated with increased self-efficacy for weight control. This randomized controlled trial investigated the effects of a weight control program on eating and smoking behaviors in a group of female, weight-concerned smokers from July 2005 to June 2006. Two hundred sixteen subjects who wanted to lose weight but were not yet ready to quit smoking were recruited to participate in a 12-week, cognitive-behavioral weight control program consisting of 12 1-hour sessions. Subjects were randomly assigned to either the weight-control program (intervention group) or the control group. Differences between the intervention and control groups were evaluated using t tests for continuous variables, Wilcoxon rank-sum tests for ordinal variables and chi(2) tests for categorical variables. The intervention group had a 14% increase (P<0.001) in self-efficacy for weight control (Weight Efficacy Life-Style Questionnaire), which was associated with improved diet quality (Healthy Eating Index) (r=0.292, P<0.01), weight loss (r=0.582, P<0.001), increased self-efficacy for quitting smoking (Smoking Self-Efficacy Questionnaire) (r=0.291, P<0.014), a decrease in number of cigarettes smoked (r=0.331, P<0.005), and positive movement in stage of change toward smoking cessation (r=0.435, P<0.001). These findings suggest that for this group of weight-concerned smokers' success in changing eating behavior may trigger a positive change in smoking behavior.
| Kristin Ito, Sri Kalyanaraman, Carol Ford, Jane Brown, William Miller|
AIDS education and prevention : official publication of the International Society for AIDS Education [20:78-89] (2008)
The purpose of this study was to develop and pilot-test an interactive CD-ROM aimed at the prevention of sexually transmitted infections (STIs) in female adolescents. The CD-ROM includes prevention information, models skills for negotiating abstinence and consistent condom use, teaches media literacy, and allows the user to choose a culturally appropriate host to guide them through the CD-ROM. Forty-seven female adolescents attending a health department clinic were randomized to receive the CD-ROM plus an educator-led didactic session versus the didactic session alone. The CD-ROM was highly acceptable and feasible for use among female adolescents in the clinic setting. Hispanic and African American adolescents were more likely to choose hosts of the same race/ethnicity to guide them through the CD-ROM. HIV/STI knowledge increased significantly and nearly all adolescents intended to use condoms at next intercourse after viewing the CD-ROM. However, there were no significant differences measured between CD-ROM and comparison groups.
| Julie Downs, Pamela Murray, Wändi Bruine de Bruin, Joyce Penrose, Claire Palmgren, Baruch Fischhoff|
Social science & medicine (1982) [59:1561-72] (2004)
A longitudinal randomized design was used to evaluate the impact of a theoretically based, stand-alone interactive video intervention on 300 urban adolescent girls' (a) knowledge about sexually transmitted diseases (STDs), (b) self-reported sexual risk behavior, and (c) STD acquisition. It was compared to two controls, representing high-quality informational interventions. One used the same content in book form; the other used commercially available brochures. Following randomization, the interventions were administered at baseline, with booster sessions at 1, 3, and 6 months. Self-reports revealed that those assigned to the interactive video were significantly more likely to be abstinent in the first 3 months following initial exposure to the intervention, and experienced fewer condom failures in the following 3 months, compared to controls. Six months after enrollment, participants in the video condition were significantly less likely to report having been diagnosed with an STD. A non-significant trend in data from a clinical PCR assay of Chlamydia trachomatis was consistent with that finding.
| Thomas Patterson, Brent Mausbach, Remedios Lozada, Hugo Staines-Orozco, Shirley Semple, Miguel Fraga-Vallejo, Prisci Orozovich, Daniela Abramovitz, Adela de la Torre, Hortensia Amaro, Gustavo Martinez, Carlos Magis-Rodríguez, Steffanie Strathdee|
American journal of public health [98:2051-7] (2008)
We examined the efficacy of a brief behavioral intervention to promote condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico.
We randomized 924 female sex workers 18 years or older without known HIV infection living in Tijuana and Ciudad Juarez who had recently had unprotected sex with clients to a 30-minute behavioral intervention or a didactic control condition. At baseline and 6 months, women underwent interviews and testing for HIV, syphilis, gonorrhea, and chlamydia.
We observed a 40% decline in cumulative sexually transmitted illness incidence (P = .049) in the intervention group. Incidence density for the intervention versus control groups was 13.8 versus 24.92 per 100 person-years for sexually transmitted illnesses combined (P = .034) and 0 versus 2.01 per 100 person-years for HIV (P < .001). There were concomitant increases in the number and percentage of protected sex acts and decreases in the number of unprotected sex acts with clients (P < .05).
This brief behavioral intervention shows promise in reducing HIV and sexually transmitted illness risk behaviors among female sex workers and may be transferable to other resource-constrained settings.
| Carol Roye, Silverman Perlmutter, Beatrice Krauss|
Health education & behavior : the official publication of the Society for Public Health Education [34:608-21] (2007)
HIV/AIDS disproportionately affects young women of color. Young women who use hormonal contraception are less likely to use condoms. Brief, inexpensive HIV-prevention interventions are needed for high-volume clinics. This study was a randomized clinical trial of two interventions: (a) a video made for this study and (b) an adaptation of Project RESPECT counseling. Four hundred Black and Latina teenage women completed a questionnaire about their sexual behaviors and were randomly assigned to (a) see the video, (b) get counseling, (c) see the video and get counseling, or (d) receive usual care. At 3-month follow-up, those who saw the video and received counseling were 2.5 times more likely to have used a condom at last intercourse with their main partner than teens in the usual care group. These differences did not persist at 12-month follow-up. This suggests that a brief intervention can positively affect condom use in the short term.