Camille Gagné

Factors explaining the intention to give blood among the general population

Background and Objectives  The aim of this study was to identify factors explaining the intention to donate blood.

Breast cancer: The intention to have a mammography and a clinical breast examination - application of the theory of planned behavior

Abstract The purpose of these cross sectional studies was to identify the psychosocial factors explaining womens intention to have a mammography within the next two years and their intention to have a clinical breast examination (CBE) by a professional within the next year. Two random samples of women aged 40–69 years (na = 354, nb = 344) completed a self-administered questionnaire that investigated theoretical constructs of the theory of planned behavior. The results of structural equation modeling showed that subjective norms and perceived behavioral control explained 81 % of the variance in intention of having a mammography. Sixty-five percent (65%) of the variance in intention of having a CBE was explained by attitude and perceived behavioral control. In conclusion, women need to be better informed, have better skills to overcome psychological and physical barriers in performing preventive breast behaviors, and promotion of preventive breast cancer methods should consider people significant for women.

Improving self-report measures of non-adherence to HIV medications

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.

Efficiency of an Evidence-Based Intervention to Promote and Reinforce Tobacco Abstinence Among Elementary Schoolchildren in a School Transition Period:

This study reports the evaluation of an intervention designedto reinforcetobacco abstinence amongelementary schoolchildren in a school transition period. This intervention was developed according to the principles of Intervention Mapping. A total of 765 grade 5 students (ages 10-12) was recruited in 32 elementary schools. A quasi-experimental longitudinal design was used to evaluate the outcomes. Results observed 2 and 8 months postintervention are reported here. It is shown that although the behavior remained largely unchanged by the intervention, some of its determinants were modified. Behavioral intention, behavioral and normative beliefs, perceived self-efficacy, and role beliefs were changed at one or both postintervention measures. An interesting feature of these results relates to the fact that the most positive outcomes were seen among at-risk children. Discussion considers the advisability to develop, implement, and evaluate evidence-based interventions targeting the psychosocial factors underlying maintenance of tobacco smoking abstinence in elementary school.

Does perceived behavioural control mediate the relationship between power beliefs and intention

OBJECTIVES In order to determine whether the relationship between power beliefs (Sigma(p)) 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(Sobel) = 5.15, p < .001; Z(Baron&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 Ajzens 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.

The impact of organizational characteristics on telehealth adoption by hospitals

Human and organizational factors are central to the adoption of various telehealth technologies and influence their diffusion into integrated networks. The aim of this paper is twofold. Firstly, a conceptual framework for assessing organizational factors that condition telehealth adoption by hospitals is proposed. Secondly, the results of an exploratory study conducted among the 32 hospitals involved in the Provincial Extended Telehealth Network of Quebec (Canada) are presented and discussed. Relevant concepts from different theoretical frameworks were combined to propose a comprehensive framework of potential factors affecting telehealth adoption by hospitals. A questionnaire was administered via telephone interviews to the DSP (Director of Medicine) of each of the 32 hospitals. Level of telehealth adoption was assessed by computing the number of transmissions performed since the hospitals adhesion to the network. Then, contingency analyses were performed to determine which organizational factors were significantly associated with telehealth adoption. Finally, the paper discusses some of the implications pertaining to the organizational dimensions affecting telehealth adoption by hospitals and proposes avenues to facilitate the diffusion of this technology.

Effect of an intervention mapping approach to promote the consumption of fruits and vegetables among young adults in junior college: A quasi-experimental study

Objective: This study evaluates the effectiveness of an intervention mapping developed to promote fruit and vegetable consumption. Design: Students (n = 394) from two similar public colleges in the Quebec City area (Canada) were asked to participate. A quasi-experimental design was used with a 14-week pause between the pretest and posttest. The control and experimental groups both received information on Canada’s Food Guide recommendations. The experimental group was submitted to an intervention consisting of six interactive workshops carried out inside the college, and three personal exercises to be completed at home. Main outcome: proportion of respondents consuming at least five servings of fruits and vegetables daily. Secondary outcomes: psychosocial variables assessed (theory of planned behaviour). Results: The data collected from 344 participants by means of a self-administered questionnaire were analysed (167 experimental and 177 control). The posttest revealed a significant increase (15%) in the number of participants in the experimental group achieving the primary outcome (d = .38). The intervention also had a significant effect on the targeted psychosocial variables (η2 = .03 to .06). Regularity of consumption acts as a mediator between intention and behaviour. Conclusion: These results may be used to guide health promoters working with college students.

Does the easy–difficult item measure attitude or perceived behavioural control?

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 totalling 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.

Promouvoir la consommation de légumes et de fruits chez des collégiens : application du protocole d’intervention mapping

Résumé: L’objectif de cet article est de présenter le processus suivi lors du développement, de la mise en œuvre et de l’évaluation d’un programme de promotion de la consommation de légumes et de fruits destiné à des collégiens. Un total de 385 collégiens québécois du Canada âgés de 18 ans en moyenne ont accepté volontairement de participer à cette étude. Le modèle de planification en six étapes de Bartholomew et collaborateurs (2006) a été utilisé. Basée sur la théorie du comportement planifié (Ajzen,1991), l’évaluation des besoins a été effectuée avec un questionnaire auto-administré développé à partir d’une revue de la littérature et de groupes de discussion focalisée auprès de collégiens. Cette première étape a permis d’identifier les déterminants psychosociaux sur lesquels intervenir spécifiquement. Les résultats consistent en un programme d’une durée de quatre heures et demie, qui a été offert à 167 collégiens (groupe expérimental). Adaptées à cette clientèle, et sur des bases théoriques, les activités incluaient l’utilisation d’outils d’auto-évaluation de la consommation quotidienne de légumes et de fruits, le calcul de portions avec une nutritionniste, un quiz sur le web, la rédaction d’un plan pour implanter ses intentions, les démonstrations culinaires de recettes d’un pair avec dégustations et tests de goût. Le programme s’est avéré efficace pour augmenter l’intention comportementale ainsi que le nombre de participants à consommer au moins cinq portions de légumes et de fruits chaque jour, à la fin du programme. Ce protocole permet de structurer une intervention sur mesure visant un changement comportemental chez une clientèle ciblée. Le développement d’un partenariat milieu/université accroît les chances de succès, tant pour l’implantation du programme que pour son efficacité.This article aims to present the development, implementation and evaluation process of a programme to promote the consumption of fruits and vegetables in high-school students. A total of 385 high-school students from Quebec, Canada, with an average age of 18 years, volunteered to take part in this study. Bartholomew’s six step planning model was used. Based on Ajzen’s planned behaviour theory, a needs assessment was carried out through a self-administered questionnaire, developed based on a literature review and high-school student focus groups. This first stage enabled the identification of specific psycho-social determinants which informed the intervention. The resulting intervention consisted in a 4.5 hour programme which was offered to 167 high-school students (experimental group). Adapted to this target group, and based on theory, activities included the use of self-evaluation tools on the consumption of fruits and vegetables, portion calculations with a nutritionist, a web survey/quiz, the drafting of a plan to set out objectives, peer culinary recipe demonstrations with tasting, and taste testing. The intervention turned out to be effective at increasing behavioural objectives as well as the number of participants consuming at least five portions of fruits and vegetables a day by the end of the programme. This protocol enables the structuring of a tailored intervention aiming at behavioural change in a target group. The development of a setting/university partnership increases chances of success both in terms of implementation of a programme and its effectiveness. (Global Health Promotion, 2012; 19(4): 65–76)