Birte Dohnke

Do hospital treatments represent a ‘teachable moment’ for quitting smoking? A study from a stage-theoretical perspective

Hospital treatments are assumed to be a ‘teachable moment’. This phenomenon, however, is only poorly conceptualised and untested. A stage-theoretical perspective implies that a cueing event such as hospital treatments is a teachable moment if a stage progression, change of cognitions, or both occur. This concept is examined in a cross-sectional study by comparing smokers in two treatment settings, an emergency department (ED) and inpatient treatment after elective surgery, with smokers in a control setting. Setting differences were hypothesised in stage distribution, and levels of and stage differences in social-cognitive factors under control for possible confounders. Stage, social-cognitive factors and possible confounders were assessed in 185 ED smokers, 193 inpatient smokers and 290 control smokers. Compared to control smokers, ED and inpatient smokers were in higher stages; they perceived fewer risks and cons; inpatient smokers reported more concrete plans. Stage differences in self-efficacy among ED and inpatient smokers differed from those among control smokers, but the former corresponded more strongly to the theoretical stage assumptions. The results suggest that hospital treatments lead to a stage progression and change of corresponding cognitions, and thus represent a ‘teachable moment’. Stage-matched interventions should be provided but consider differences in cognitions to be effective.

Motivation and participation in a phase III cardiac rehabilitation programme: an application of the health action process approach.

This longitudinal study extends the previous research on low participation rates and high dropout rates in phase III cardiac rehabilitation (CR) exercise programmes. It examines the correlates of motivation and participation 6 months after inpatient phase II CR (T1) and the predictors of dropout 6 months later (T2) using the health action process approach (HAPA). Risk perception, outcome expectancies, self-efficacy, intention (at T1), and participation (at T1 and T2) in relation to phase III CR programmes was assessed in 456 patients. Based on intention and participation at T1, patients were classified as nonintenders (56%), intenders (13%), or actors (31%). Group differences were confirmed in outcome expectancies and self-efficacy. By T2, 21% of T1 actors had dropped out. Dropouts and maintainers differed in intention and self-efficacy (at T1). Results are in line with the HAPA and suggest a perspective for tailoring motivational counselling to improve participation in phase III CR programmes.

Adolescents’ eating behaviour in general and in the peer context: Testing the prototype-willingness model

Objective: To investigate the prototype-willingness model (PWM) for eating behaviour in general and in the peer context in order to gain further evidence on the PWM and social-reactive processes in adolescents’ eating behaviour. Design: A longitudinal study was conducted. PWM variables for unhealthy and healthy eating were assessed at baseline in 356 adolescents (mean age 12.61 years). Main Outcome Measures: Eating behaviour was measured four weeks after baseline by two indicators: general eating pattern index (self-report) and consumption of unhealthy and healthy snacks in the peer context (behavioural observation). For both, structural equation models were conducted introducing PWM variables for either unhealthy or healthy eating. Results: The PWM was mainly confirmed for the eating pattern index; intention, willingness and prototype perception had direct effects. Differences between unhealthy and healthy eating were found. Moreover, the PWM contributed to the prediction of healthy, but not unhealthy, snack consumption over and above current hunger; willingness had a direct effect. Conclusions: The PWM can be applied to predict and understand adolescents’ eating behaviour. Social-reactive processes, namely willingness and prototype perception, are behavioural determinants that should be considered in theory and as novel targets in health promotion interventions.

Der Einfluss von Ergebnis- und Selbstwirksamkeitserwartungen auf die Ergebnisse einer Rehabilitation nach Hüftgelenkersatz

Zusammenfassung. In einer prospektiven Beobachtungsstudie wurde an 1065 Patienten der Einfluss von Reha-Motivationen (d.h. Ergebniserwartungen und Selbstwirksamkeitserwartungen) auf die Ergebnisse einer Rehabilitation nach Huftgelenkersatz untersucht. Die Ergebnisse der Langsschnittanalysen bestatigten, dass Patienten umso bessere Reha-Ergebnisse (d.h. geringere Schmerzen, weniger eingeschrankte Aktivitaten des taglichen Lebens) am Reha-Ende hatten, je positiver ihre Ergebniserwartungen und je hoher ihre Selbstwirksamkeitserwartungen zu Reha-Beginn waren. Hohe Selbstwirksamkeitserwartungen verstarkten die positive Wirkung der Ergebniserwartungen. In Querschnittsanalysen wurde der Einfluss des korperlichen Gesundheitszustands, des emotionalen Wohlbefindens und behandlungsbezogener Erfahrungen auf beide Erwartungstypen zu Reha-Beginn untersucht. Beide Erwartungstypen waren umso hoher ausgepragt, je besser der korperliche Gesundheitszustand war. Zudem waren Selbstwirksamkeitserwartungen umso hoher, je gering...

Motivation von Rehabilitationspatienten zur Teilnahme an einer Herzgruppe

Zusammenfassung. Die vorliegende Studie wahlt erstmalig einen gesundheitsverhaltenstheoretischen Ansatz zur Untersuchung der Herzgruppenteilnahme und untersucht mit der Wahl des sozial-kognitiven Prozessmodells gesundheitlichen Handelns die Annahmen dieses Stadienmodells erstmalig fur die Teilnahme an einem Aktivitatsprogramm. Gepruft werden die Annahmen, dass sich die drei Stadien Motivation, Intention und Handlung fur eine regelmasige Herzgruppenteilnahme sechs Monate nach Entlassung aus einer stationaren kardiologischen Phase II Rehabilitation finden lassen und dass Risikowahrnehmung, Konsequenz- und Selbstwirksamkeitserwartungen stadienspezifisch bedeutsam sind (Diskontinuitatshypothese). Die Stichprobe stammt aus dem 6-Monats Follow-up der CARO II Studie (N = 640). Die Ergebnisse bestatigen die Diskontinuitatshypothese fur Risikowahrnehmung, negative Konsequenzerwartungen sowie fur Selbstwirksamkeitserwartungen. Positive Konsequenzerwartungen hingegen steigen linear uber die drei Stadien an. Zusammen...

Image des gesunden und ungesunden Essers im Jugendalter

Zusammenfassung: Das Ernährungsverhalten ist durch eine Vielzahl von Faktoren beeinflusst. Soziale Faktoren sind im Jugendalter von besonderer Bedeutung. Das Image des gesunden und ungesunden Essers ist ein Faktor, an dem verhaltenspräventive Maßnahmen ansetzen können. Es hängt nachweislich mit dem Ernährungsverhalten zusammen und ist veränderbar. Image-bezogene Strategien lassen sich als Einzelmaßnahme und im Rahmen umfassenderer Programme zur ernährungsbezogenen Gesundheitsförderung und Prävention einsetzen.

Fluid Intake and Cognitive Performance: Should Schoolchildren Drink During Lessons?

BACKGROUND Evidence suggests that an insufficient fluid intake impairs cognitive performance. Drinking policies at schools-especially drinking during lessons-is a point of controversy. To provide a scientific base for this debate, more empirical evidence is needed on which aspects of fluid intake are crucial for cognitive performance. This study makes a contribution by investigating associations between quantitative and temporal aspects of fluid intake and cognitive performance in everyday school life. METHODS The study comprised 125 children (age: mean = 10.98 years, SD = 0.38). Amount of fluid intake and time span between fluid intake and completion of cognitive tests were determined on basis of self-reports. Cognitive performance was assessed by standardized tests. RESULTS Quantitative and temporal aspects were associated with cognitive performance: The more fluid the children consumed and the shorter the time span between their last fluid intake and test completion, the better they performed. CONCLUSIONS The amount of fluid intake should be adequate and moreover the time span between intake and cognitive efforts should be as short as possible. Schoolchildren are thus recommended to drink at regular intervals and also during lessons.

Stress, coping, and health behaviors

Abstract. Research of the Division of Educational Psychology and Health Psychology has four main topics: 1. Analysis of processing of threat-related information in children is seen as a step towards a better understanding and assessment of vigilant and avoidant coping strategies. 2. Findings concerning gender differences in stress and coping in children and adolescents show that girls in early and middle adolescence display a more favorable coping pattern in social relations than their male peers. Therefore, a focus on the gender-specific development of coping strategies is needed when tailoring programs in stress prevention. 3. Social influences in the context of health behavior change are studied in adults. Cross-sectional and longitudinal studies focus on risk perception, intention formation, and behavior adoption. 4. Aims of the network of school based health promotion are implementation and evaluation of health promoting activities along with the opportunity for networking and training possibilities ...