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Background: Short instruments measuring frequency of specific foods, such as fruit and vegetable (FV), are increasingly used in interventions. The objective of the study was to verify the validity and test-retest reliability of such an instrument among pregnant women.Methods: Pregnant women from the region of Quebec City, Quebec, Canada, were recruited through e-mails sent to female students and employees of the local university from October 2014 to April 2015. To assess the validity of the fruit and vegetable questionnaire (FVQ) developed by Godin et al. (Can J Public Health 99: 494-498, 2008), pregnant women were asked in a first mailing to complete the FVQ assessing FV intake over the past 7 days and a 3-day estimated food record. A subsample (n = 33) also gave a fasting blood sample and completed a validated semi-quantitative FFQ administered by a trained registered dietitian during a visit at the research center. FV intakes for all instruments were calculated in terms of servings of FV based on Canada's Food Guide definition of a serving of fruit or vegetable. In order to assess its test-retest reliability, respondents were asked to complete the FVQ 14 days later in a second mailing.Results: Forty-eight pregnant women from all three trimesters completed the questionnaires in the first mailing. FV intake assessed using the FVQ was correlated to FV consumption measured using the food record (r = 0.34, p = 0.0180) and the FFQ (r = 0.61, p = 0.0002). Results were similar when controlling for energy intake and the experience of nausea in the past month. Only β-cryptoxanthin was significantly correlated to FV intake assessed by the FFQ when adjusted for the presence of nausea (r = 0.35, p = 0.0471). Data on the test-retest reliability was available for 44 women and the intra-class coefficient for the FVQ was 0.72 at a mean 28-day interval.Conclusions: The FVQ has acceptable validity and test-retest reliability values, but seems to underestimate FV servings in pregnant women. It represents an interesting alternative for researchers or clinicians interested in estimating quickly FV intake among pregnant women, such as in large trials or during prenatal visits. The FVQ should however be coupled with other self-reported measures, such as a food record, for assessing precise individual FV intake. [ABSTRACT FROM AUTHOR]

Background: Excessive salt intake has been directly associated with cardiovascular diseases, especially hypertension, and non-cardiovascular diseases. Despite the current recommendations, salt intake remains high, indicating the need to develop theory-based interventions aimed at reducing this intake. Aim: The purpose of this study was to test the impact of a theory-based intervention - the SALdável Program – to promote the use of less than 4 g of salt/day during cooking. Methods: This was a two-arm parallel-group randomized study. A total of 92 hypertensive women were randomly assigned to an intervention or control group. The intervention was aimed at motivating participants to reduce salt addition by increasing self-efficacy and counteracting the negative influence of habit. Primary outcomes were the behavioral question of salt addition and total salt addition, secondary outcomes were overall salt intake, provided by 24-hour urinary sodium excretion, and psychosocial variables (intention, self-efficacy, and habit). Results: At three-month follow-up, the intervention group improved significantly more than the control group regarding salt addition measures (p-values between 0.05 and 0.001) and psychosocial variables (all p-values ⩽0.001). The reduction in 24-hour urinary sodium excretion was not significant. Conclusion: The findings showed that this theory-based intervention was effective to motivate and change the behavior of hypertensive women regarding daily salt use in cooking meals. This was accomplished by means of improvements in intention and self-efficacy and reduction of the habit of using more than 4 g of salt/day during cooking. [ABSTRACT FROM AUTHOR]

Background: Most studies on euthanasia fail to explain the intentions of health professionals when faced with performing euthanasia and are atheoretical. Research objective: The purpose of this study was to identify the psychosocial determinants of nurses’ intention to practise euthanasia in palliative care if it were legalised. Research design: A cross-sectional study using a validated anonymous questionnaire based on an extended version of the Theory of Planned Behaviour. Participants and research context: A random sample of 445 nurses from the province of Quebec, Canada, was selected for participation in the study. Ethical considerations: The study was reviewed and approved by the Ethics Committee of the Centre hospitalier universitaire de Québec. Findings: The response rate was 44.2% and the mean score for intention was 4.61 ± 1.90 (range: 1–7). The determinants of intention were the subjective (odds ratio = 3.08; 95% confidence interval: 1.50–6.35) and moral (odds ratio = 2.95; 95% confidence interval: 1.58–5.49) norms. Specific beliefs which could discriminate nurses according to their level of intention were identified. Discussion: Overall, nurses have a slightly positive intention to practise euthanasia. Their family approval seems particularly important and also the approval of their medical colleagues. Nurses’ moral norm was related to beneficence, an ethical principle. Conclusion: To our knowledge, this is the first study to identify nurses’ motivations to practise euthanasia in palliative care using a validated psychosocial theory. It also has the distinction of identifying the ethical principles underlying nurses’ moral norm and intention. [ABSTRACT FROM AUTHOR]

Background: The Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) is one of the most often used questionnaires in oncology research, yet modifications to the scale are done with little evidence of psychometric testing. This study aimed to (i) document the frequency of use of the questionnaire for ranking (i.e., level of activity) and classification (i.e., active versus insufficiently active) purposes, (ii) summarize how the GSLTPAQ is used in terms of item content and scoring, and (iii) evaluate the extent to which validity evidence supports the use of the scale among cancer survivors. Methods: A systematic review was conducted with evidence drawn from English-written articles published between January 1st 1985 (year the GSLTPAQ was published) and December 31, 2014. A search of six databases, a scan of reference list of included articles, and a cited reference search identified articles that reported using the GSLTPAQ among cancer survivors. Results: A total of 212 articles were retrieved. The GSLTPAQ was used for classifying cancer survivors into active and insufficiently active categories in 51 % of the articles. Moreover, a modified version of the questionnaire was used in 81 % of the research studies. Three studies reported validity evidence based on the relationship between the scores on the GSLTPAQ (i.e., leisure score index, LSI) and accelerometer or pedometer-derived activity data. Validity evidence supporting the use of the GSLTPAQ for assessing changes in LSI was computed from six randomized trials. Conclusions: The use of the GSLTPAQ for classification purpose in oncology research is common. Standardization in the use and interpretation of the GSLTPAQ in oncology research is warranted. Although limited, there is support for using the original form of the GSLTPAQ and interpreting the LSI for ranking cancer survivors from the lowest to highest levels of leisure-time physical activity. [ABSTRACT FROM AUTHOR]

Summary .— This study provided validity evidence for the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) to classify respondents into active and insuffi ciently active categories. Members of a fi tness center [45 women and 55 men; mean ( SD ) age = 45.5 (10.6) yr.] completed the questionnaire. Using only moderate and strenuous scores, those with a leisure score index ≥ 24 were classifi ed as active ; those with a score ≤ 23 were classifi ed as insuffi ciently active . VO 2 max, percentage of body fat, and electronic records of fi tness center attendance were the validation variables. In a visit to the fi tness center, participants completed the GSLTPAQ and a certifi ed exercise specialist performed a physical fi tness evaluation. A multivariate analysis of covariance (MANCOVA) indicated the group of respondents classifi ed as active had higher VO 2 max and lower percentage of body fat than the group of respondents classifi ed as insuffi ciently active . An analysis of covariance (ANCOVA) indicated the group of respondents classifi ed as active had higher electronic records of fi tness center attendance than the group of respondents classifi ed as insuffi ciently active . Therefore, these pieces of validity evidence support the use of the questionnaire's classifi cation system among healthy adults. [ABSTRACT FROM AUTHOR]

Background: Most people with type 2 diabetes do not engage in regular leisure-time physical activity. The theory of planned behavior and moral norm construct can enhance our understanding of physical activity intention and behavior among this population. Purpose: This study aims to identify the determinants of both intention and behavior to participate in regular leisure-time physical activity among individuals with type 2 diabetes who not meet Canada's physical activity guidelines. Method: By using secondary data analysis of a randomized computer-tailored print-based intervention, participants ( n = 200) from the province of Quebec (Canada) completed and returned a baseline questionnaire measuring their attitude, perceived behavioral control, and moral norm. One month later, they self-reported their level of leisure-time physical activity. Results: A hierarchical regression equation showed that attitude (beta = 0.10, P < 0.05), perceived behavioral control (beta = 0.37, P < 0.001), and moral norm (beta = 0.45, P < 0.001) were significant determinants of intention, with the final model explaining 63 % of the variance. In terms of behavioral prediction, intention (beta = 0.34, P < 0.001) and perceived behavioral control (beta = 0.16, P < 0.05) added 17 % to the variance, after controlling the effects of the experimental condition ( R = 0.04, P < 0.05) and past participation in leisure-time physical activity ( R = 0.22, P < 0.001). The final model explained 43 % of the behavioral variance. Finally, the bootstrapping procedure indicated that the influence of moral norm on behavior was mediated by intention and perceived behavioral control. Conclusion: The determinants investigated offered an excellent starting point for designing appropriate counseling messages to promote leisure-time physical activity among individuals with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Aim. The purpose of this study is to evaluate the impact, among nurses in hospital settings, of a questionnaire-based implementation intentions intervention on notification of potential ocular tissue donors to donation stakeholders. Methods. This randomized intervention was clustered at the level of hospital departments with two study arms: questionnaire-based implementation intentions intervention and control. In the intervention group, nurses were asked to plan specific actions if faced with a number of barriers when reporting potential ocular donors. The primary outcome was the potential ocular tissue donors' notification rate before and after the intervention. Analysis was based on a generalized linear model with an identity link and a binomial distribution. Results. We compared outcomes in 26 departments from 5 hospitals, 13 departments per condition. The implementation intentions intervention did not significantly increase the notification rate of ocular tissue donors (intervention: 23.1% versus control: 21.1%; χ² = 2.14,2; P = 0.56). Conclusion. A single and brief implementation intentions intervention among nurses did not modify the notification rate of potential ocular tissue donors to donation stakeholders. Low exposure to the intervention was a major challenge in this study. Further studies should carefully consider a multicomponent intervention to increase exposure to this type of intervention. [ABSTRACT FROM AUTHOR]

The purpose of this study was to provide three construct validity evidence for using fitness center attendance electronic records to objectively assess the frequency of leisure-time physical activity among adults. One hundred members of a fitness center (45 women and 55 men; aged 18 to 64 years) completed a self-report leisure-time physical activity questionnaire. The theory of planned behavior constructs (e.g., intention and perceived behavioral control), VO2max, and % BF were assessed. Fitness center attendance electronic records were expressed as the weekly mean number of mandatory check-in records retrieved from the fitness center's electronic database over a 12-week period prior to participant's physical fitness evaluation. A continuous (frequency) and categorical (“adherent” versus “non-adherent”) scores were computed. Results indicated that perceived behavioral control was associated with fitness center attendance electronic records and mediated the fitness center attendance electronic records–intention relationship. Fitness center attendance electronic records were associated with VO2max and self-report leisure-time physical activity. Therefore, results provide three evidence of construct validity of using fitness center attendance electronic records scores to assess leisure-time physical activity behavior. [ABSTRACT FROM PUBLISHER]

Background The aim of the study was to predict a first lifetime plasma donation among whole blood donors. Study Design and Methods A sample of 252 whole blood donors, who never donated plasma, completed the study questionnaire assessing intention, attitudes, subjective norm, and perceived behavioral control toward giving plasma. The dependent variables were intention to give plasma and first lifetime plasma donation within 6 months. Results At 6 months, 57 individuals had made 98 plasma donations. First lifetime plasma donation was predicted by intention (p < 0.05) and age (50+ years, p < 0.05). Intention was determined by attitudes (p < 0.001) and perceived behavioral control (p < 0.001). Conclusion Promotional strategies to recruit new plasma donors should target individuals aged 50 years and more. Such strategies should be coupled with actions to lower the perceived barriers and highlight the perceived advantages of becoming a plasma donor. [ABSTRACT FROM AUTHOR]

Background Approximately 12% to 15% of blood donors are temporarily deferred from giving blood because they fail relevant medical criteria. Temporary deferral has a profound negative impact on subsequent donation. To our knowledge, an implementation intentions intervention has never been tested among temporarily deferred donors. We hypothesized that return rates would be higher among participants exposed to an implementation intentions intervention compared to those in a control condition that is mere measurement of related cognitions. Study Design and Methods Participants were assigned to implementation intentions or mere measurement conditions; whether or not participants received a temporary interdiction on giving blood was measured. A total of 956 novice donors were temporarily deferred (n = 490, in the implementation intentions condition; n = 466, in the mere measurement condition). Participants in the implementation intentions condition formed if-then plans to overcome three common barriers to blood donation: forgetting to attend, fitting the opportunity to give blood into one's schedule, and organizing transportation to the donation venue. Participants in the mere measurement condition did not form plans. Results Participants in the implementation intentions condition had a 19% greater chance of returning to give blood again within the 4 years after their first lifetime donation compared to participants in the mere measurement condition (p = 0.04) when controlling for sex and attempt at which participants were deferred. Conclusion The results of this study indicate that implementation intentions could be a useful strategy for promoting donor return among temporarily deferred novice blood donors. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify the psychosocial and socio-demographic determinants of physical activity maintenance (PAM) among adults by examining baseline differences between individuals who did and did not maintain physical activity participation over time (Part-I) and by examining how well combinations of psychosocial constructs and socio-demographic characteristics predict PAM (Part-II). Longitudinal and experimental studies (sample mean age 18–64 years) published between 1980 and 2010 were included. Independent data extraction was performed by two reviewers. All pooled effect sizes were calculated with the inverse-variance method under the random-effects model assumption. A total of 31 and 22 studies met all inclusion criteria and were included in Part-I and Part-II meta-analysis, respectively. Maintainers had higher [standard mean difference (95%CI)] self-efficacy (0.62 [0.49, 0.76]) and intention (0.65 [0.52, 0.79]) compared with relapsers. Health status directly affected PAM and moderated the relationship between BMI, education as well as perceived negative consequences and PAM. The overall model adjustedR2[95%CI] for the prediction of PAM was 0.20 [0.14, 0.27]. The present findings suggest that beliefs about capabilities and motivation and goals are among the strongest variables associated with PAM. However, other variables rarely investigated so far (e.g., post-intentional constructs/self-regulatory processes) may also influence PAM. [ABSTRACT FROM AUTHOR]

Implementation intentions are a powerful strategy to promote health-related behaviours, but mixed results are observed regarding physical activity. The primary aim of this study was to systematically and quantitatively review the literature on the effectiveness of implementation intentions on physical activity. The second aim was to identify conditions under which effectiveness is optimal. A literature search was performed in several databases for published and non-published reports. The inverse variance method with random effect model was used for the meta-analysis of results. Effect sizes were reported as standard mean differences. Twenty-six independent studies were included in the systematic review. The overall effect size of implementation intentions was 0.31, 95% confidence intervals (CI) [0.11, 0.51] at post-intervention and 0.24, 95% CI [0.13, 0.35] at follow-up. The duration of follow-up had no significant effect on effect size (F(1, 18) = 0.21,p=0.66. This strategy was more effective among student and clinical samples, and when barrier management was part of implementation intentions. The present meta-analysis provides support for the use of implementation intentions to promote physical activity, even though the effect size is small to medium. [ABSTRACT FROM AUTHOR]

Objectives: Physical activity is a key factor for healthy ageing and obesity management. The aim of this study was to test the effect of implementation intentions (IIs) on physical activity and body weight among inactive obese older adults. Design and measures: At baseline, 101 obese (classes I and II) older adults were randomised to an experimental or a control condition. IIs were delivered in the experimental condition in addition to the common intervention activities. Physical activity (primary outcome) was assessed by means of pedometers. The effect of IIs on body weight (secondary outcome) was also evaluated. Results: No main effects for IIs were observed for all outcomes (ps > 0.21). A significant time × condition interaction was observed for the number of steps per day (p = 0.01). At the 6-month follow-up, the improvement in physical activity was greater among participants in the experimental condition (d = 0.59). None of the measured cognitions moderated or mediated IIs. Conclusion: Results suggest that IIs could be appropriate to favour the maintenance of physical activity among inactive obese older adults. However, this technique seems to have limited impacts over and above common intervention activities on weight loss. [ABSTRACT FROM PUBLISHER]

ObjectiveFollowing the adoption of food policies replacing unhealthy products by healthy foods in school, the present study tested the effectiveness of an intervention aimed at encouraging high-school students to stay in school for lunch instead of eating in fast-food restaurants.DesignA 12-week multi-strategy intervention targeting specific determinants of behaviour was evaluated via a quasi-experimental pre- and post-intervention design. A self-administered questionnaire was employed based on the theory of planned behaviour.SettingAn experimental (n 129) and a control school (n 112) in central Canada.SubjectsHigh-school students aged 12 to 17 years.ResultsCompared with control school students, those in the experimental school significantly increased the mean number of days that they stayed in school for lunch (relative risk = 1·55; 95 % CI 1·06, 2·27; P = 0·024), as well as the proportion who remained in school for lunch every day (relative risk = 1·21; 95 % CI 1·04, 1·40; P = 0·014). Among the psychosocial variables targeted, only self-efficacy appeared to be influenced by the intervention, mainly because of a decline in control group values. Mediation analysis indicated a significant mediating effect of self-efficacy on the mean number of days that students stayed in school for lunch (bias-corrected and accelerated point estimate = 0·079; 95 % CI 0·0059, 0·1958).ConclusionsThese results suggest that interventions aimed at enhancing self-efficacy can successfully contribute to students staying in school during lunch time. Such interventions should be considered in obesity prevention programmes adapted to high-school students. [ABSTRACT FROM PUBLISHER]

Objective: This study investigated the question–behaviour effect of measuring intention in the interrogative or declarative form combined or not with a measure of moral norm. Design: A sample of 762 participants was randomised according to a 2 × 2 factorial design. Main outcome measures: Cognitions were assessed at the baseline, and physical activity behaviour was self-reported three weeks later. Results: At baseline, there were no significant differences on the studied variables. An ANOVA showed a significant interaction effect between the two experimental conditions (p = 0.04). Post-hoc contrast analyses showed that the interrogative intention-only condition significantly differed from the declarative intention-only (d = 0.21, p = 0.03) and interrogative intention + moral norm (d = 0.22, p = 0.03) conditions. Conclusion: Results suggest that self-posed questions about a future action increases the likelihood of doing it when these questions are not accompanied by measures of moral norm. This provides support for using introspective self-talk to favour the adoption of behaviour. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the question–behaviour effect of measuring intention in the interrogative or declarative form combined or not with a measure of moral norm. Design: A sample of 762 participants was randomised according to a 2 × 2 factorial design. Main outcome measures: Cognitions were assessed at the baseline, and physical activity behaviour was self-reported three weeks later. Results: At baseline, there were no significant differences on the studied variables. An ANOVA showed a significant interaction effect between the two experimental conditions (p = 0.04). Post-hoc contrast analyses showed that the interrogative intention-only condition significantly differed from the declarative intention-only (d = 0.21, p = 0.03) and interrogative intention + moral norm (d = 0.22, p = 0.03) conditions. Conclusion: Results suggest that self-posed questions about a future action increases the likelihood of doing it when these questions are not accompanied by measures of moral norm. This provides support for using introspective self-talk to favour the adoption of behaviour. [ABSTRACT FROM AUTHOR]

Background: Living with HIV makes considerable demands on a person in terms of self-management, especially as regards adherence to treatment and coping with adverse side-effects. The online HIV Treatment, Virtual Nursing Assistance and Education (Virus de I'immunodéficience Humaine-Traitement Assistance Virtuelle Infirmière et Enseignement; VIH-TAVIE™) intervention was developed to provide persons living with HIV (PLHIV) with personalized follow-up and real-time support in managing their medication intake on a daily basis. An online randomized controlled trial (RCT) will be conducted to evaluate the efficacy of this intervention primarily in optimizing adherence to combination anti-retroviral therapy (ART) among PLHIV. Methods/design: A convenience sample of 232 PLHIV will be split evenly and randomly between an experimental group that will use the web application, and a control group that will be handed a list of websites of interest. Participants must be aged 18 years or older, have been on ART for at least 6 months, and have internet access. The intervention is composed of four interactive computer sessions of 20 to 30 minutes hosted by a virtual nurse who engages the PLHIV in a skills-learning process aimed at improving self-management of medication intake. Adherence constitutes the principal outcome, and is defined as the intake of at least 95% of the prescribed tablets. The following intermediary measures will be assessed: self-efficacy and attitude towards antiretroviral medication, symptom-related discomfort, and emotional support. There will be three measurement times: baseline (T0), after 3 months (T3) and 6 months (T6) of baseline measurement. The principal analyses will focus on comparing the two groups in terms of treatment adherence at the end of follow-up at T6. An intention-to-treat (ITT) analysis will be carried out to evaluate the true value of the intervention in a real context. Discussion: Carrying out this online RCT poses various challenges in terms of recruitment, ethics, and data collection, including participant follow-up over an extended period. Collaboration between researchers from clinical disciplines (nursing, medicine), and experts in behavioral sciences information technology and media will be crucial to the development of innovative solutions to supplying and delivering health services. Trial registration: CE 11.184 / NCT 01510340 [ABSTRACT FROM AUTHOR]

This study tested the effect of interventions designed for people who do not eat yet the recommended daily fruit and vegetable intake (FVI) but have a positive intention to do so. Adults (N = 163) aged 20–65 were randomised into four groups: implementation intentions (II group), self-efficacy (SE group), combination of II + SE group) and a control group receiving written information on nutrition. Study variables were measured at baseline, post-intervention and at 3-month follow-up. At follow-up, compared to the control group, FVI increased significantly in the II and II + SE groups (1.5 and 1.9 servings per day, respectively). Most psychosocial variables significantly increased compared to the control group, with the exception of SE for vegetable intake (VI). Moreover, at 3-month follow-up, change in FVI was mediated by changes in fruit intake (FI) intention and VI action planning. In conclusion, II interventions were efficient to increase FVI, with or without consideration for the development of SE. Thus, future studies should favour the adoption of this approach to bridge the intention–behaviour gap for FVI. [ABSTRACT FROM PUBLISHER]

BACKGROUND: A strategy used by blood centers to retain donors is to place phone call reminders. However, among first-time donors, no studies have tested the effect of this strategy. This was the aim of this study among individuals who had recently given their first lifetime blood donation. STUDY DESIGN AND METHODS: A quasi-experimental study using a nonequivalent control group was adopted; participants in the control group were donors with blood types B+ and AB+, since these individuals are not phoned by the blood agency. A total of 1604 first-time donors aged 18 to 70 years from the province of Quebec, Canada, were assigned to the experimental (n = 870) or the control (n = 734) group. Participants in the experimental group were phoned a few days before they had a new opportunity to give blood while those in the control condition were not phoned. RESULTS: In the experimental condition, 48.3% of the donors attempted to give blood during the 12-month follow-up period compared to 38.0% in the control condition. The hazards of the first blood donation attempt among donors who were phoned were 32% higher compared to the hazards of those who were not phoned (p = 0.0004). CONCLUSION: The results of this study indicate that a first phone call reminder about the upcoming opportunity to give blood again has a significant positive effect on return rates among first-time donors. [ABSTRACT FROM AUTHOR]

This study aimed at examining the predictors of initiation into drug injection among street youth using social cognitive theory framework. A prospective cohort study based on semi-annual interviews was carried out. Psychosocial determinants referred to avoidance of initiation. Other potential predictors were: sociodemographic characteristics, relationships with injectors, parent's substance misuse, drug use patterns, homelessness, survival sex, sexual abuse. Independent predictors were identified using Cox proportional hazards regression models. Among the 352 participants, high control beliefs about avoidance of initiation was protective while younger age, daily alcohol consumption, heroin use, cocaine use, and survival sex all increased risk of initiation. Preventive strategies targeting street youth should both enhance youth's control beliefs and actual control over their substance use and improve their life conditions. [ABSTRACT FROM AUTHOR]

In many countries, not drinking alcohol during pregnancy is strongly recommended, since consuming alcohol can be hazardous for the unborn child. Despite this, a number of women drink alcohol while pregnant. The two objectives of the study were to identify (1) the determinants of intention to abstain from drinking alcohol while pregnant among 167 women of childbearing age between 18 and 44 years and (2) the factors that programmes promoting alcohol abstinence during pregnancy should consider. Data were collected using a questionnaire based on an extended version of the theory of planned behaviour. A large majority of the participants reported consuming alcohol on a regular basis. Although most of them expressed a strong intention to abstain from alcohol during pregnancy, about one woman in four did not have a firm intention. A logistic regression analysis revealed that the four determinants of intention were moral norm (odds ratio (OR) == 12.97; 95%% confidence interval (CI95%%): 3.83--43.91), anticipated regret (OR == 11.43; CI95%%: 3.46--37.75), attitude (OR == 7.49; CI95%%: 2.37--23.64) and perceived behavioural control (OR == 3.60; CI95%% 1.11--11.65). Moreover, a discriminant analysis identified specific beliefs significantly related to intention not to consume alcohol while pregnant. These results can prove useful in guiding the development of a programme promoting alcohol abstinence among women of childbearing age in order to reduce the number of unborn children exposed to alcohol during pregnancy. [ABSTRACT FROM AUTHOR]

Background: The promotion of physical activity among an overweight/obese population is an important challenge for clinical practitioners and researchers. In this regard, completing a questionnaire on cognitions could be a simple and easy strategy to increase levels of physical activity. Thus, the aim of the present study was to test the effect of completing a questionnaire based on the Theory of Planned Behavior (TPB) on the level of physical activity. Methods: Overall, 452 overweight/obese adults were recruited and randomized to the experimental or control group. At baseline, participants completed a questionnaire on cognitions regarding their participation in leisuretime physical activity (experimental condition) versus a questionnaire on fruit and vegetable consumption (control condition). The questionnaires assessed the TPB variables that are beliefs, attitude, norm, perception of control, intention and a few additional variables from other theories. At three-month follow-up, leisure-time physical activity was self-reported by means of a short questionnaire. An analysis of covariance with baseline physical activity level as covariate was used to verify the effect of the intervention. Results: At follow-up, 373 participants completed the leisure-time physical activity questionnaire. The statistical analysis showed that physical activity participation was greater among participants in the experimental condition than those in the control condition (F(1,370) = 6.85, p = .009, d = 0.20). Conclusions: Findings indicate that completing a TPB questionnaire has a significant positive impact on subsequent participation in physical activity. Consequently, asking individuals to complete such a questionnaire is a simple, inexpensive and easy strategy to increase the level of physical activity among overweight/obese adults. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this study is twofold: to identify the determinants of daily fruit and vegetable (F&V) consumption and the moderators of the intention–behaviour relationship. A sample of 225 overweight or obese adults completed a TPB questionnaire. F&V behaviour was assessed at baseline and three months later. Statistical analyses revealed that past behaviour, perceived behavioural control (PBC) and age were significant predictors of daily F&V consumption. In addition, intention was found to interact with anticipated regret. Interventions should encourage the development of habit and PBC. However, the age and level of anticipated regret of the targeted population should be considered when designing interventions. [Copyright &y& Elsevier]

The aim of this study was to assess the effects of implementation intentions on leisure-time physical activity, taking into account the stability of intention. At baseline (T0), 349 participants completed a psychosocial questionnaire and were randomly assigned to implementation intention or control condition. Three months after baseline assessment (T1), participants in the experimental group were asked to plan where, when, and how they would exercise. Leisure-time physical activity was assessed 3 mo. later (i.e., at 6-mo. follow-up; T2). The intervention had no significant effect on physical activity at 6-mo. follow-up. However, a significant interaction of group and intention stability was observed, with the effect of the intervention on behaviour statistically significant only among those with unstable intention. Intention stability thus moderated the effect of the intervention, i.e., the intervention was more successful among individuals who needed support to change (unstable intenders). [ABSTRACT FROM AUTHOR]

Objective. This study investigated the combined influence of social structural factors (e.g. income) and cognitions in predicting changes in physical activity. Four models were tested: (a) direct effects (social structural factors influence behaviour controlling for cognitions), (b) mediation (cognitions mediate social structural influence), (c) moderation (social structural factors moderate cognition-behaviour relations), and (d) mediated moderation (cognitions mediate the moderating effects of social structural position). Design. Baseline and 3-month follow-up surveys. Methods. A random sample of 1,483 adults completed self-report measures of physical activity at baseline and 3-month follow-up. Measures of age, gender, education, income, material and social deprivation, intention, perceived behavioural control (PBC), and intention stability also were taken. Results. Apart from age, social structural factors exhibited very small or marginal effects on behaviour change, and only education moderated the intention-behaviour relation. In contrast, the magnitude of direct effects of the social cognition variables was comparatively large and intention stability mediated the moderating effect of education. Conclusions. Stable intentions and PBC are the key predictors of changes in physical activity. Consequently, our findings would suggest the value of focusing on cognitions rather than social structural variables when modelling the determinants of physical activity. [ABSTRACT FROM AUTHOR]

Background: The quest for greater efficiency in the provision of primary healthcare services and the implementation of a "health-promoting school" approach encourage the optimal redefinition of the role of school nurses. School nurses are viewed as professionals who might be significant actors in the promotion of youth health. The aim of this study was to identify the determinants of the intention of elementary school nurses to adopt a new health-promotion role as a strategic option for the health-promoting school.Methods: This study was based on an extended version of the theory of planned behaviour (TPB). A total of 251 respondents (response rate of 70%) from 42 school health programs across the Province of Québec completed a mail survey regarding their intention to adopt the proposed health-promotion role. Multiple hierarchical linear regression analyses were performed to assess the relationship between key independent variables and intention. A discriminant analysis of the beliefs was performed to identify the main targets of action.Results: A total of 73% of respondents expressed a positive intention to accept to play the proposed role. The main predictors were perceived behavioural control (β = 0.36), moral norm (β = 0.27), attitude (β = 0.24), and subjective norm (β = 0.21) (ps < .0001), explaining 83% of the variance. The underlying beliefs distinguishing nurses who had a high intention from those who had a low intention referred to their feelings of being valued, their capacity to overcome the nursing shortage, the approval of the school nurses' community and parents of the students, their leadership skills, and their gaining of a better understanding of school needs.Conclusions: Results suggest that leadership is a skill that should be addressed to increase the ability of school nurses to assume the proposed role. Findings also indicate that public health administrators need to ensure adequate nurse staffing in the schools in order to increase the proportion of nurses willing to play such a role and avoid burnout among these human resources. [ABSTRACT FROM AUTHOR]

Background: Accumulating evidence suggests that fruit and vegetable intake (FVI) plays a protective role against major diseases. Despite this protective role and the obesity pandemic context, populations in Western countries usually eat far less than five servings of fruits and vegetables per day. In order to increase the efficiency of interventions, they should be tailored to the most important determinants or mediators of FVI. The objective was to systematically review social cognitive theory-based studies of FVI and to identify its main psychosocial determinants. Methods: Published papers were systematically sought using Current Contents (2007-2009) and Medline, Embase, PsycINFO, Proquest and Thesis, as well as Cinhal (1980-2009). Additional studies were identified by a manual search in the bibliographies. Search terms included fruit, vegetable, behaviour, intention, as well as names of specific theories. Only studies predicting FVI or intention to eat fruits and vegetables in the general population and using a social cognitive theory were included. Independent extraction of information was carried out by two persons using predefined data fields, including study quality criteria. Results: A total of 23 studies were identified and included, 15 studying only the determinants of FVI, seven studying the determinants of FVI and intention and one studying only the determinants of intention. All pooled analyses were based on random-effects models. The random-effect R2 observed for the prediction of FVI was 0.23 and it was 0.34 for the prediction of intention. Multicomponent theoretical frameworks and the theory of planned behaviour (TPB) were most often used. A number of methodological moderators influenced the efficacy of prediction of FVI. The most consistent variables predicting behaviour were habit, motivation and goals, beliefs about capabilities, knowledge and taste; those explaining intention were beliefs about capabilities, beliefs about consequences and perceived social influences. Conclusions: Our results suggest that the TPB and social cognitive theory (SCT) are the preferable social cognitive theories to predict behaviour and TPB to explain intention. Efficacy of prediction was nonetheless negatively affected by methodological factors such as the study design and the quality of psychosocial and behavioural measures. [ABSTRACT FROM AUTHOR]

Beyond the risk of HIV and HVC transmission associated with needle sharing, re-using one's own syringe constitutes an additional risk for injection drug users (IDUs). This practice can lead to serious infections such as cellulitis and endocarditis. In order better to target interventions promoting the adoption of this behaviour, this study attempts to identify factors associated with IDUs' intention always to use a new syringe. The Theory of Planned Behaviour was applied in the development of the questionnaire administered to 117 IDUs during an interview. Over a period of 1 week, 35.7% of respondents failed to consistently use new syringes and only 39% of the entire sample indicated a firm intention to adopt this behaviour. A regression analysis demonstrated that perceived behavioural control and attitude predicted intention. Results indicate that interventions should serve primarily to help IDUs recognize the advantages of adopting this behaviour and develop skills to overcome certain obstacles. [ABSTRACT FROM AUTHOR]

Background: In recent years, there has been growing interest in theoretical studies integrating cognitions and environmental variables in the prediction of behaviour related to the obesity epidemic. This is the approach adopted in the present study in reference to the theory of planned behaviour. More precisely, the aim of this study was to determine the contribution of cognitive and environmental variables in the prediction of active commuting to get to and from work or school. Methods: A prospective study was carried out with 130 undergraduate and graduate students (93 females; 37 males). Environmental, cognitive and socio-demographic variables were evaluated at baseline by questionnaire. Two weeks later, active commuting (walking/bicycling) to get to and from work or school was self-reported by questionnaire. Hierarchical multiple regression analyses were performed to predict intention and behaviour. Results: The model predicting behaviour based on cognitive variables explained more variance than the model based on environmental variables (37.4% versus 26.8%; Z = 3.86, p < 0.001). Combining cognitive and environmental variables with socio-demographic variables to predict behaviour yielded a final model explaining 41.1% (p < 0.001) of the variance. The significant determinants were intention, habit and age. Concerning intention, the same procedure yielded a final model explaining 78.2% (p < 0.001) of the variance, with perceived behavioural control, attitude and habit being the significant determinants. Conclusion: The results showed that cognitive variables play a more important role than environmental variables in predicting and explaining active commuting. When environmental variables were significant, they were mediated by cognitive variables. Therefore, individual cognitions should remain one of the main focuses of interventions promoting active commuting among undergraduate and graduate students. [ABSTRACT FROM AUTHOR]

In this paper the development of a self-management program to optimize long-term adherence to antiretroviral therapy for people living with HIV/AIDS is presented. The program is based on intervention mapping: that is, a framework that facilitates the use of theory and empirical evidence in intervention development. In the preparatory phase we conducted a needs-assessment. The results of this phase were then used in the operational phase in which the program was elaborated as follow: in Step 1 we established program objectives; in Step 2 we translated theoretical methods into practical strategies; and in Step 3 we integrated the strategies into a self-management program which were designed to help individuals mobilize their skills to cope with their antiretroviral therapies (ART). These particular abilities are: ability to integrate ART in daily routine, to cope with side effects, to handle situations in which ART is difficult to take, to interact with health professionals and to maintain relationships with social contacts. To address individuals' resources and skills in conjunction with the experience of taking the medication, we developed two different modalities to deliver the intervention: direct support and virtual support. Direct support consists of four 45-minute individualized, face-to-face sessions with a health professional. The Web application involved at least four interactive sessions with a computer. This application was developed with the intention to support individuals in managing their therapy, in a punctual, real-time mode. Treatment adherence behavior is an indicator or gauge that can reveal problems in being able to manage the therapy. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify factors associated with the maintenance of a high intention of avoiding initiation into drug injection among street youths. A prospective cohort study of street youths aged 14 to 23 was initiated in Montreal in July 2001. A total of 330 street youths who had never injected drugs and had completed at least one semi-annual follow-up questionnaire were included in the analysis. The prediction of the maintenance of a high intention over given time intervals of 6 to 36 months was assessed. At baseline, 83.6% of the respondents firmly intended avoiding initiation into drug injection. Maintenance of high intention was significantly associated with the maintenance of high values of perceived control, attitude and role beliefs. These results clearly demonstrate that youths who maintain a high intention of avoiding initiation into drug injection hold more favourable cognitions over time. [ABSTRACT FROM AUTHOR]

Background: There is an important gap between the implications of clinical research evidence and the routine clinical practice of healthcare professionals. Because individual decisions are often central to adoption of a clinical-related behaviour, more information about the cognitive mechanisms underlying behaviours is needed to improve behaviour change interventions targeting healthcare professionals. The aim of this study was to systematically review the published scientific literature about factors influencing health professionals' behaviours based on social cognitive theories. These theories refer to theories where individual cognitions/thoughts are viewed as processes intervening between observable stimuli and responses in real world situations. Methods: We searched psycINFO, MEDLINE, EMBASE, CIHNAL, Index to theses, PROQUEST dissertations and theses and Current Contents for articles published in English only. We included studies that aimed to predict healthcare professionals' intentions and behaviours with a clear specification of relying on a social cognitive theory. Information on percent of explained variance (R²) was used to compute the overall frequency-weighted mean R² to evaluate the efficacy of prediction in several contexts and according to different methodological aspects. The cognitive factors most consistently associated with prediction of healthcare professionals' intention and behaviours were documented. Results: Seventy eight studies met the inclusion criteria. Among these studies, 72 provided information on the determinants of intention and 16 prospective studies provided information on the determinants of behaviour. The theory most often used as reference was the Theory of Reasoned Action (TRA) or its extension the Theory of Planned Behaviour (TPB). An overall frequency-weighted mean R² of 0.31 was observed for the prediction of behaviour; 0.59 for the prediction of intention. A number of moderators influenced the efficacy of prediction; frequency-weighted mean R² varied from 0.001 to 0.58 for behaviour and 0.19 to 0.81 for intention. Conclusion: Our results suggest that the TPB appears to be an appropriate theory to predict behaviour whereas other theories better capture the dynamic underlying intention. In addition, given the variations in efficacy of prediction, special care should be given to methodological issues, especially to better define the context of behaviour performance. [ABSTRACT FROM AUTHOR]

Background: Intention is a key determinant of action. However, there is a gap between intention and behavioural performance that remains to be explained. Therefore, the aim of this study was to identify moderators of the intention-behaviour and perceived behavioural control (PBC)-behaviour relationships for leisure-time physical activity. Method: This was tested in reference to Ajzen's Theory of Planned Behaviour. A sample of 300 volunteers, 192 women and 108 men, aged 18 to 55, participated in the study. At baseline, the participants completed a self-administrated psychosocial questionnaire assessing Ajzen's theory variables (i.e., intention and perceived behavioural control). The behavioural measure was obtained by mail three months later. Results: Multiple hierarchical regression analyses indicated that age and annual income moderated the intention-behaviour and PBC-behaviour relationships. However, in the final model predicting behaviour (R² = .46), only the interaction term of PBC by annual income (β = .24, p = 0.0003) significantly contributed to the prediction of behaviour along with intention (β = .49, p = 0.0009) and past behaviour (β = .44, p < 0.0001). Conclusion: Physical activity promotion programs would benefit not only from focusing on increasing the intention of low intenders, but also from targeting factors that moderate the perceived behavioural control-behaviour relationships. [ABSTRACT FROM AUTHOR]

Seven prospective studies of health behaviours containing eight prospective datasets testing the moderating role of intention stability on intention-behaviour and past behaviour-behaviour relationships were examined within the context of the Theory of Planned Behaviour. The measure of intention stability was based on lack of change in intentions between the two measurement time points. Across different behaviours, samples and time frames more stable intentions were associated with intentions at time 1 that were stronger predictors of behaviour at time 2. Intention stability did not consistently moderate the past behaviour-behaviour relationship. Across studies the frequency-weighted mean correlation between intentions and behaviour was substantially greater for stable (r+ = 0.60) compared to unstable (r+ = 0.27) intentions (Zdifference = 6.65, p < 0.001). The past behaviour-behaviour correlation was also stronger for stable (r+ = 0.50, p < 0.001) compared to unstable (r+ = 0.34, p < 0.001) intentions (Zdifference = 3.12, p < 0.01). Perceived behavioural control was the variable most strongly related to stable intentions. Implications for understanding the role of health cognitions in the performance of health behaviour are discussed. [ABSTRACT FROM AUTHOR]

Objective. In order to determine if easy-difficult item measures attitude or perceived behavioural control (PBC), we used structural equation modelling of 10 cross-sectional data sets. Design. Cross-sectional design was used. Method. Ten studies that examined health-related behaviours and used the theory of planned behaviour as a theoretical framework were analysed. Samples totaling N = 4,552 participants were employed. All studies involved multi-item measures of attitude (Aact) and PBC items derived from pilot testing. Results. Confirmatory factor analysis confirmed the discriminant validity of Aact and PBC. Structural equation modelling of relevant path indicated that in three studies, easy-difficult item is an indicator of both Aact and PBC. In the other seven studies, easy-difficult item belongs to PBC. The indexes of meta-analysis suggest that overall, easy-difficult item is an indicator of PBC. Conclusion. Findings from 10 studies converged toward the conclusion that the easy-difficult item is an indicator of perceived PBC. However, since the easy-difficult item is sometimes classified as both Aact and PBC, and only the perceived difficulty dimension of PBC captures a significant increment in the variance of intention, it appears important to develop and validate a set of items devoted to measure the perceived difficulty dimension adequately. [ABSTRACT FROM AUTHOR]

BACKGROUND: The maintenance of a safe level of blood supply is provided by a small number of volunteers, and their retention is difficult. The aim of this study was to identify factors predicting repeated blood donation among experienced and new donors. STUDY DESIGN AND METHODS: A random sample of 2231 donors (2070 experienced and 161 new) completed a questionnaire assessing psychosocial factors as defined by the most prominent social cognitive theories. Six months later, an objective measure of frequency of registrations to give blood was obtained from the database of the local official agency for blood donation. RESULTS: Logistic regression analysis indicated that for experienced donors, the predictors were intention, perceived control, anticipated regret, moral norm, age, and frequency of blood donation in the past. For new donors, intention and age were the only determinants of behavior. Important differences in the determinants of intention were also noted between experienced and new donors. CONCLUSION: In summary, the results of this study support the idea that distinct promotion strategies should be adopted to increase repeated blood donation among experienced versus new donors. [ABSTRACT FROM AUTHOR]

The authors' goal was to identify factors explaining intention to encourage a patient to follow complementary and alternative medicine (CAM) treatment among general practitioners (GPs), fourth-year medical students, and residents in family medicine. They surveyed 500 GPs and 904 medical studentsvia a self-administered mailed questionnaire that they based on the Theory of Planned Behavior. Respondents expressed a neutral level of intention to encourage CAM approach. Variables explaining 75% of variance of intention of all participants were: moral norm, β = 0.34, p < .0001; perceived behavioral control, β = 0.29, p < .0001; attitude, β = 0.22, p < .0001; descriptive norm, β = 0.13, p < .0001; and professional status, (GPs, β = -0.07, p < .0001; residents, β = -0.07, p < .0001). Facilitating conditions and developing a better perception of control over perceived obstacles could help enhance health-care practitioners' intentions to use CAM. Also, a clear position on the part of the medical community would help to define a professional norm in line with the moral norm. [ABSTRACT FROM AUTHOR]

Abstract: Persons who inject drugs and attend shooting galleries are at high-risk of HIV-seroconversion. However, this population does not easily lend itself to classical HIV-transmission prevention strategies such as increased access to sterile injection material, community outreach and long term drug use treatment. To identify factors likely to be useful in designing specific interventions for this population, a questionnaire assessing social cognitive and sociodemographic variables was administered to 92 injection drug users attending shooting galleries (SG attendees). A follow-up interview was held 6 months later among 40 participants. Factors assessed where used to build models predicting SG attendees’ intention (n =88) and behaviour (n =37) not to inject with syringes used by others. SG attendees’ intention to adopt a safe injection practice was determined by self-efficacy and perceived behavioural control whereas behaviour was predicted by self-efficacy. Models were not affected by other variables such as gender, age, HIV serostatus, or past sharing behaviour. Considering the high HIV prevalence found among the study population (22%), it is concluded that SG attendees should be given tools to improve their capacity to adopt safe injection practices. Our results suggest that working on their self-efficacy might prove an effective way to intervene among this population. [Copyright &y& Elsevier]

This research examined whether intentions aligned with moral norms better predict behaviour compared with intentions aligned with attitudes. Six data sets predicting behaviours in the health domain (smoking, driving over speed limit, applying universal precautions, exercising) were analysed. Moderated regression analysis indicated that participants whose intentions were more aligned with their moral norm were more likely to perform behaviours compared with participants whose intentions were more aligned with their attitude. However, further analysis indicated that this moderation effect was only present when participants construed the behaviour in moral terms. The findings suggest that the theory of planned behaviour should more clearly acknowledge the importance of internalized norms and self-expectations in the development of one's motivation to adopt a given behaviour. [ABSTRACT FROM AUTHOR]

The aim of this article is to clarify what factors should be measured to assess non-adherence to an antiretroviral medication regimen among individuals with the Human Immunodeficiency Virus (HIV). In order to consider a patient as non-adherent, a clear operational definition of medication non-adherence should be formulated. This definition should specify the medication to be taken, the medical advice to be followed as well as the behaviors a patient should adopt in a given period of time. Techniques aimed at reducing the influence of several potential biases in self-report questionnaires, such as forgetfulness and social desirability, are also reviewed. [ABSTRACT FROM AUTHOR]

Purpose. The purpose of this study was to identify the fact on explaining regular physical activity among Canadian adolescents. Design. A cohort study conducted over a period of 2 years. Setting. A French-language high school located near Québec City. Subjects. A cohort of 740 students (352 girls; 388 boys) aged 13.3 ± 1.0 years at baseline. Measures. Psychosocial, life context, profile, and sociodemographic variables were assessed at baseline and 1 and 2 years after baseline. Exercising almost every day during leisure time at each measurement time was the dependent variable. Results. The Generalized Estimating Equations (GEE) analysis indicated that exercising almost every day was significantly associated with a high intention to exercise (odds ratio [OR]: 8.33, confidence interval [CI]95%: 5.26, 13.18), being satisfied with the activity practiced (OR: 2.07, CI95%: 1.27, 3.38), perceived descriptive norm (OR 1.82, CI95%: 1.41, 2.35), being a boy (OR: 1.83, CI95%: 1.37, 2.46), practicing "competitive" activities (OR: 1.80, CI95%: 1.37, 2.36), eating a healthy breakfast (OR: 1.68, CI95%: 1.09, 2.60), and normative beliefs (OR: 1.48, CI95%: 1.14, 1.90). Specific GEE analysis for gender indicated slight but significant differences. conclusions. This study provides evidence for the need to design interventions that are gender specific and that focus on increasing intention to exercise regularly. [ABSTRACT FROM AUTHOR]

Objectives. The aim of this study was to identify the determinants of single heterosexuals' use of condoms during each sexual intercourse. Design. Cohort of individuals followed over a period of 2 years. Methods. Respondents were 574 single heterosexual individuals who answered questions during a telephone interview. Results. Attitude, perceived behavioural control, self‐efficacy and moral norm explained 65% of the variance in intentions to use condoms (p <.0001). The determinants of condom use at 1 year follow‐up (27% explained variance) were perceived behavioural control, past behaviour, and the interaction between intention and intention stability. At 2 years follow‐up, the significant determinants were past behaviour and intention by intention stability. In the present study, intentions to use condoms which remained stable across time were strong predictors of condom use (at 1 year: β=.42, p <.0001; at 2 years: β=.39, p <.003), while unstable intentions were not (at 1 year: β=.02, ns; at 2 years: β=.19, ns). Conclusion. Intention stability is a major determinant of the accuracy of intention for the prediction of subsequent behaviour. [ABSTRACT FROM AUTHOR]

Background: Theory-based approaches are advocated to improve our understanding of prescription behaviour. This study is an application of the theory of planned behaviour (TPB) with additional variables. It was designed to assess which variables were associated with the intention to prescribe hormone therapy (HT). In addition, variations in the measures across medical specialities (GPs and gynaecologists) and across countries (France and Quebec) were investigated. Methods: A survey among 2,000 doctors from France and 1,044 doctors from Quebec was conducted. Data were collected by means of a self-administered questionnaire. A clinical vignette was used to elicit doctors' opinions. The following TPB variables were assessed: attitude, subjective norm, perceived behavioural control, attitudinal beliefs, normative beliefs and power of control beliefs. Additional variables (role belief, moral norm and practice pattern-related factors) were also assessed. A stepwise logistic regression was used to assess which variables were associated with the intention to prescribe HT. GPs and gynaecologists were compared to each other within countries and the two countries were compared within the specialties. Results: Overall, 1,085 doctors from France returned their questionnaire and 516 doctors from Quebec (response rate = 54% and 49%, respectively). In the overall regression model, power of control beliefs, moral norm and role belief were significantly associated with intention (all at p < 0.0001). The models by specialty and country were: for GPs in Quebec, power of control beliefs (p < 0.0001), moral norm (p < 0.01) and cytology and hormonal dosage (both at p < 0.05); for GPs in France, power of control beliefs and role belief (both at p < 0.0001) and perception of behavioural control (p < 0.05) and cessation of menses (p < 0.01); for gynaecologists in Quebec, moral norm and power of control beliefs (both at p = 0.01); and for gynaecologists in France, power of control beliefs (p < 0.0001), and moral norm, role belief and lipid profile (all at p < 0.05). Conclusion: In both countries, compared with GPs, intention to prescribe HT was higher for gynaecologists. Psychosocial determinants of doctors' intention to prescribe HT varied according to the specialty and the country thus, suggesting an influence of contextual factors on these determinants. [ABSTRACT FROM AUTHOR]

Objectives. In order to determine whether the relationship between power beliefs (Σp) and health-related behavioural intentions is mediated by perceived behavioural control (PBC) we used structural equation modelling of eight cross-sectional data sets. Method. Eight studies that examined health-related behaviours and employed representative samples totalling N = 4663 participants were analysed. All studies involved power belief items derived from pilot testing and employed standard multi-item measures of power beliefs, PBC and intention that were highly reliable. Results. Confirmatory factor analysis confirmed the discriminant validity of power beliefs, PBC and intention. Structural equation modelling of relevant paths indicated that PBC only partially mediated the relationship between power beliefs and intention (Z[subSobel] = 5.15; p < .001; Z[subBaron&Kenny] = 5.16; p < .001). Power beliefs had a significant direct relationship with intention even after PBC had been taken into account. Conclusion. The findings undermine Ajzen's contention that PBC mediates the power beliefs-intention relationship and suggests that it is important to employ measures of power beliefs in addition to measures of PBC in order to enhance the prediction of intentions to perform health-risking, or health-promoting, behaviours. [ABSTRACT FROM AUTHOR]

Background. Despite the progress made in smoking prevention among youth, few scientific reports have identified the determinants underlying the abstinence from cigarettes, and even fewer have made an assessment of their evolution over time. It has been proposed that this could be done by modeling after theoretical frameworks.Methods. A self-reported questionnaire developed according to Ajzen''s Theory of Planned Behavior was repeatedly administered to a cohort of 373 grade 5 students (191 girls and 182 boys) during their transition from elementary to secondary school. Four measures spanning a 26-month period were thus obtained and analyzed according to the GEE method.Results. After 26 months, 76.14% of the students in the sample remained abstinent from cigarettes. The perceived smoking behaviors of friends and of a brother, intention over time, perceived self-efficacy, parental supervision, and socioeconomic status predicted the maintenance of abstinence from smoking. The final predictive model had a sensitivity of 79.8% and a specificity of 75.6%, with an average rate of accurate classification of 79.1%.Conclusions. The predictive model yielded by this study represents an important step toward developing tools to help 10–12 years olds maintaining their abstinent behavior. It emphasizes positive protective factors and guides health promoters in the choice of their interventions'' contents and targets. [Copyright &y& Elsevier]

Objective: The aim of this study was to compare two approaches to classify individuals into stages of motivational readiness for physical activity and test which one was better explained by attitude and perceived behavioural control, as defined by Ajzen (1991). Design: A survey of 20430 respondents from a population-based sample. Methods: The relevant variables were assessed in a self-administered questionnaire. The cluster approach consisted of combining both intention and behaviour in order to determine clusters of individuals; such clusters correspond to different stages of motivational readiness. The stage of change (SC) approach consisted of grouping the same individuals by using the SC variable of the Transtheoretical Model (TTM). Results: The SC and cluster-solution approaches were replicated across four subsamples of the total number of respondents. Attitude and perceived behavioural control were more strongly associated with stage membership derived from four-cluster solution than with stage membership in the five categories assessed by the SC method. Conclusion: Stage of motivational readiness for physical activity, and possibly for other health-related behaviours, may usefully be characterized when both recent past behaviour and intention in the near future are simultaneously and explicitly taken into consideration. [ABSTRACT FROM AUTHOR]

Physicians'' acceptance of telemedicine constitutes a prerequisite for its diffusion on a national scale. Based upon the Theory of Interpersonal Behavior, this study was aimed at assessing the predictors of physicians'' intention to use telemedicine in their clinical practice. All of the physicians involved in the RQTE, the extended provincial telemedicine network of Quebec (Canada) were mailed a questionnaire to identify the psychosocial determinants of their intention to adopt telemedicine. Confirmatory factor analysis (CFA) was performed to assess the measurement model and structural equation modelling (SEM) was applied to test the theoretical model. The adapted theoretical model explained 81% (P<0.001) of variance in physicians'' intention to use telehealth. The main predictors of intentions were a composite normative factor, comprising personal as well as social norms (β=1.08; P<0.001) and self identity (β=−0.33; P<0.001). Thus, physicians who perceived professional and social responsibilities regarding adoption of telehealth in their clinical practice had stronger intention to use this technology. However, it is likely that personal identity had a suppression effect in the regression equation, indicating that physicians'' intention to use telemedicine was better predicted if their self-perception as telemedicine users was considered. These results have several implications at the theoretical and practical levels that are discussed in this paper. [Copyright &y& Elsevier]

The aim of this study was to verify the validity of a new self-reported questionnaire designed to assess nonadherence to antiretroviral medication among patients with HIV. Two hundred fifty-six patients from four clinics participated in a prospective longitudinal study. The questionnaire was designed to measure if patients with HIV were taking less than the total number of antiretroviral pills prescribed by their physician. Change in viral load was used as the criterion for validity analyses. Self-reported adherence, viral load and CD4 cell count were assessed at T[sub 0] (baseline), T[sub 3] (3-month), and T[sub 6] (6-month). The findings indicated that the questionnaire had adequate validity (sensitivity, 71%; specificity, 72%; correct classification, 72%; odd ratio, 6.15). These best values were obtained when the analyses excluded individuals with an unstable viral load and a CD4 cell count of less than 200 copies per milliliter over the 6- month follow-up period. This study has shown that this questionnaire has satisfactory psychometric qualities to assess nonadherence to antiretroviral medication among patients with HIV. The questionnaire is brief, simple, and can be used in both clinical or research settings regardless of the patients' antiretroviral regimens. [ABSTRACT FROM AUTHOR]