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A recent debate in Health Psychology Review demonstrated the importance of careful attention to measurement and operationalisation of health psychology constructs (Beauchamp, 2016; Brewer, 2016; de Vries, 2016; Schwarzer & McAuley, 2016; Williams & Rhodes, 2016a, 2016b). This need is met by rapid developments in the theory and measurement of health psychology constructs as evidenced by recent publications and conference contributions (e.g. Dima et al., 2014). However, these enhanced methods have been slow to disseminate into research practice. One reason may be that the new perspectives afforded by these developments and the related tools were not part of the curricula of most researchers currently active in health psychology. This lack of familiarity may manifest itself as an obstacle that appears difficult to overcome, thereby obstructing wide-spread use of these methods in research. The goal of the sixth Methods in Health Psychology symposium, held at the annual EHPS conference in Aberdeen in 2016, was to address this by increasing attendees’ familiarity with several new developments in this field. The symposium brought together five contributions, combining theory and methods from qualitative and quantitative traditions to provide a broad overview of the state of the art, limitations of current practices, and options for improvement. Moreover, the symposium aimed to give its attendants practical suggestions to apply these insights, as well as facilitate access to their corresponding tools. The symposium started with the presentation from Gjalt-Jorn Peters of a novel perspective on the nature and inter-relations of psychological variables and implications for their measurement. This perspective facilitates a flexible and theoretically promiscuous approach to operationalization and measurement, affording researchers more flexibility in the development and assessment of measurement instruments. This was followed by the presentation of Anne Marie Plass introducing tools to explore and improve operationalization in questionnaire development or adaptation using Cognitive Interviewing. Several problems with common assumptions about validity were pointed out and solutions provided for addressing these. Rik Crutzen provided an overview of the current practices regarding assessment of the quality of measurement instruments. Although these practices are strongly rooted in classical testing theory, important assumptions of the statistical models used were routinely violated. An accessible, freely-available procedure for improvement was introduced and explained. Alexandra Dima demonstrated stepwise procedures that leverage psychometric techniques to improve the understanding and operationalization of psychological constructs. Chris Gibbons introduced computer adaptive testing using Concerto, an open source system based on the flexible R and mySQL platforms, and discussed its benefits for health psychology research. At the end of the symposium, Frank Doyle summarized the five previous contributions and proposed several directions regarding how these insights can be implemented in practice to improve the standard of measurement in health psychology. The presentations and additional materials are available on the Open Science Framework through links on the Health Psychology Methods page on the EHPS website at http://ehps.net/content/health-psychology-methods. These materials are available under the Creative Commons Attribution license, unless indicated otherwise. Below, each contribution is briefly summarized from the perspective of this symposium.

Purpose: The presence of chronic illness has been consistently associated with depressive symptoms, and both are associated with decreased physical activity. This paper examines how level of depressive symptoms and perceived general health are associated with 12-week attendance at a CBCIR. Methods: Participants with established chronic illnesses referred to Med Ex via GPs and hospitals completed a MedEx questionnaire (Cronbach alpha >0.8 on all instruments) at induction. This instrument assessed perceived general health (1 item), presence of depressive symptoms (8 items), and self-reported days of 30 minutes of moderate to vigorous physical activity (days.30mins.MVPA; 2 items). Subsequently, attendance (defined as a visit to a MedEx class) was objectively monitored for 12 weeks. Results: 156 participants (M age=66.08+11.09, 54% Male) completed induction. 47% were classified as having no depressive symptoms, 30% had mild symptoms, while 23% had moderate, moderate to severe, or severe symptoms. 18% reported their health to be excellent or very good, 42% good, and 40% fair or poor. Group differences were revealed in terms of perceived wellness and physical activity (days.30mins.MVPA) at baseline, individuals reporting their health as fair/poor were significantly less active than those in the very good/excellent health group (Fair/poor=2.68+2.12, very good/Ex=4.82+2.0, p

Background: Physical activity is a principal intervention in primary and secondary prevention of chronic illness. While the benefits of community based rehabilitation is acknowledged,the rate of attendance and adherence remains sub optimal. Self-efficacy is acknowledged to be a key factor relating to adherence in rehabilitation but the construct of proxy efficacy, defined as one’s confidence in the skills and abilities of a third party to function effectively on another’s behalf, is less often studied. This paper examines the relationship between gender and ‘self’ and ‘proxy-efficacy’ and their potential role in attendance to a community based chronic illness rehabiliation (CBCIR) programme. Methods: Participants attending induction at the programme completed a questionnaire assessing demographics and both self (9 items) and proxy efficacy for exercise (9 items) which was assessed on a Likert scale from 0 (not confident at all) to 10 (very confident), with a higher score indicating greater efficacy. Subsequently, attendance was objectively monitored by researchers at exercise sessions for 24 weeks. Results: 69 participants (M age=65.5 +9.8 years, 56% Male) completed all measures. Mean proxy-efficacy and mean self-efficacy is significantly greater in women compared to men (p

Background: Multi-morbidity and chronic conditions pose a threat to population health. Despite known benefits of rehabilitation using structured exercise, uptake to such programmes remain sub-optimal. The aim of this study is to identify the psychosocial and health related fitness correlates of uptake to a CBCIR in men and women, with the secondary aim of identifying the rate of uptake. Methods: Participants referred to a CBCIR via GPs and hospitals completed an induction process. This introduced them to the CBCIR programme and got them to complete a multi-section questionnaire (including instruments on physical activity, exercise self-efficacy, intentions for exercise, and perceived family/friend social support) and complete a battery of physical health measures (including the Incremental shuttle walk test (ISWT), a lower body strength test and body mass index (BMI)). Post induction participants who attended an exercise class were classified as ‘Uptakers’, whilst those who never came back were classified as ‘Non-Uptakers’. Class attendance was objectively monitored by the researchers. Data were analysed using SPSS, and are presented using means, standard deviations and proportions, group differences are examined via t-tests and logistic regression was used to predict uptake. Results: A total of 441 participants (56% male; average age 64.3 ±12 years completed induction measures. Overall, 77% were identified as Uptakers (81% female, 74% male, p=0.068, 2-sided). Among men, Uptakers reported more days of 30mins moderate to vigorous physical activity (t(111) = -2.499, p

Lisa Mellon,1 Frank Doyle,1 Daniela Rohde,1 David Williams,2 Anne Hickey1 1Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland; 2Department of Geriatric and Stroke Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland Background: Patient delay in presenting to hospital with stroke symptoms remains one of the major barriers to thrombolysis treatment, leading to its suboptimal use internationally. Educational interventions such as mass media campaigns and community initiatives aim to reduce patient delays by promoting the signs and symptoms of a stroke, but no consistent evidence exists to show that such interventions result in appropriate behavioral responses to stroke symptoms. Methods: A systematic literature search and narrative synthesis were conducted to examine whether public educational interventions were successful in the reduction of patient delay to hospital presentation with stroke symptoms. Three databases, MEDLINE, CINAHL, and PsycINFO, were searched to identify quantitative studies with measurable behavioral end points, including time to hospital presentation, thrombolysis rates, ambulance use, and emergency department (ED) presentations with stroke. Results: Fifteen studies met the inclusion criteria: one randomized controlled trial, two time series analyses, three controlled before and after studies, five uncontrolled before and after studies, two retrospective observational studies, and two prospective observational studies. Studies were heterogeneous in quality; thus, meta-analysis was not feasible. Thirteen studies examined prehospital delay, with ten studies reporting a significant reduction in delay times, with a varied magnitude of effect. Eight studies examined thrombolysis rates, with only three studies reporting a statistically significant increase in thrombolysis administration. Five studies examined ambulance usage, and four reported a statistically significant increase in ambulance transports following the intervention. Three studies examining ED presentations reported significantly increased ED presentations following intervention. Public educational interventions varied widely on type, duration, and content, with description of intervention development largely absent from studies, limiting the potential replication of successful interventions. Conclusions: Positive intervention effects were reported in the majority of studies; however, methodological weaknesses evident in a number of studies limited the generalizability of the observed effects. Reporting of specific intervention design was suboptimal and impeded the identification of key intervention components for reducing patient delay. The parallel delivery of public and professional interventions further limited the identification of successful intervention components. A lack of studies of sound methodological quality using, at a minimum, a controlled before and after design was identified in this review, and thus studies incorporating a rigorous study design are required to strengthen the evidence for public interventions to reduce patient delay in stroke. The potential clinical benefits of public interventions are far-reaching, and the challenge remains in translating knowledge improvements and correct behavioral intentions to appropriate behavior when stroke occurs. Keywords: acute stroke treatment, prehospital delay, onset to door times, public education, professional education, interventions