Darren Mays

The Use of Theory in Health Behavior Research from 2000 to 2005: A Systematic Review

BackgroundTheory-based health behavior change programs are thought to be more effective than those that do not use theory. No previous reviews have assessed the extent to which theory is used (that is, operationalized and tested) in empirical research.PurposeThe purpose of this study was to describe theory use in recent health behavior literature and to assess the proportion of research that uses theory along a continuum from: informed by theory to applying, testing, or building theory.MethodsA sample of empirical research articles (n = 193) published in ten leading public health, medicine, and psychology journals from 2000 to 2005 was coded to determine whether and how theory was used.ResultsOf health behavior articles in the sample, 35.7% mentioned theory. The most-often-used theories were The Transtheoretical Model, Social Cognitive Theory, and Health Belief Model. Most theory use (68.1%) involved research that was informed by theory; 18% applied theory; 3.6% tested theory; and 9.4% sought to build theory.ConclusionsAbout one third of published health behavior research uses theory and a small proportion of those studies rigorously apply theory. Patterns of theory use are similar to reports from the mid-1990s. Behavioral researchers should strive to use theory more thoroughly by applying, testing, and building theories in order to move the field forward.

Health Information–Seeking Behaviors, Health Indicators, and Health Risks

OBJECTIVES We examined how different types of health information-seeking behaviors (HISBs)-no use, illness information only, wellness information only, and illness and wellness information combined-are associated with health risk factors and health indicators to determine possible motives for health information seeking. METHODS A sample of 559 Seattle-Tacoma area adults completed an Internet-based survey in summer 2006. The survey assessed types of HISB, physical and mental health indicators, health risks, and several covariates. Covariate-adjusted linear and logistic regression models were computed. RESULTS Almost half (49.4%) of the sample reported HISBs. Most HISBs (40.6%) involved seeking a combination of illness and wellness information, but both illness-only (28.6%) and wellness-only (30.8%) HISBs were also widespread. Wellness-only information seekers reported the most positive health assessments and the lowest occurrence of health risk factors. An opposite pattern emerged for illness-only information seekers. CONCLUSIONS Our findings reveal a unique pattern of linkages between the type of health information sought (wellness, illness, and so on) and health self-assessment among adult Internet users in western Washington State. These associations suggest that distinct health motives may underlie HISB, a phenomenon frequently overlooked in previous research.

Sports Participation and Problem Alcohol Use A Multi-Wave National Sample of Adolescents

BACKGROUND Sports participation, though offering numerous developmental benefits for youths, has been associated with adolescent alcohol use. Differences also exist between men/boys and women/girls in both sports participation and patterns of alcohol-related behaviors, but there are few longitudinal investigations of this relationship. PURPOSE This study investigated the relationship between school-based sports participation and alcohol-related behaviors using data from a multiwave national study of adolescent men/boys and women/girls. METHODS Nationally representative data from the National Longitudinal Study of Adolescent Health, collected between 1994 and 2001, were analyzed in 2009 (n=8271). Latent growth modeling, accommodating the complex sampling design, was applied to examine whether participation in school-based sports was associated with initial levels and change in problem alcohol use over three waves of data collection. RESULTS After taking into account time-invariant covariates including demographics and other predictors of alcohol use, greater involvement in sports during adolescence was associated with faster average acceleration in problem alcohol use over time among youths who took part in only sports. The findings suggest, however, that the relationship between sports participation and problem alcohol use depends on participation in sports in combination with other activities, but it does not differ between men/boys and women/girls. CONCLUSIONS Sports may represent an important and efficient context for selective interventions to prevent problem alcohol use and negative consequences of alcohol use among adolescents.

Health-Risk Correlates of Video-Game Playing Among Adults

BACKGROUND Although considerable research suggests that health-risk factors vary as a function of video-game playing among young people, direct evidence of such linkages among adults is lacking. PURPOSE The goal of this study was to distinguish adult video-game players from nonplayers on the basis of personal and environmental factors. It was hypothesized that adults who play video games, compared to nonplayers, would evidence poorer perceptions of their health, greater reliance on Internet-facilitated social support, more extensive media use, and higher BMI. It was further hypothesized that different patterns of linkages between video-game playing and health-risk factors would emerge by gender. METHODS A cross-sectional, Internet-based survey was conducted in 2006 with a sample of adults from the Seattle-Tacoma area (n=562), examining health risks; media use behaviors and perceptions, including those related to video-game playing; and demographics. Statistical analyses conducted in 2008 to compare video-game players and nonplayers included bivariate descriptive statistics, stepwise discriminant analysis, and ANOVA. RESULTS A total of 45.1% of respondents reported playing video games. Female video-game players reported greater depression (M=1.57) and poorer health status (M=3.90) than female nonplayers (depression, M=1.13; health status, M=3.57). Male video-game players reported higher BMI (M=5.31) and more Internet use time (M=2.55) than male nonplayers (BMI, M=5.19; Internet use, M=2.36). The only determinant common to female and male video-game players was greater reliance on the Internet for social support. CONCLUSIONS A number of determinants distinguished video-game players from nonplayers, and these factors differed substantially between men and women. The data illustrate the need for further research among adults to clarify how to use digital opportunities more effectively to promote health and prevent disease.

Smoking-related deaths averted due to three years of policy progress

OBJECTIVE To evaluate the global impact of adopting highest-level MPOWER tobacco control policies in different countries and territories from 2007 to 2010. METHODS Policy effect sizes based on previously-validated SimSmoke models were applied to determine the reduction in the number of smokers as a result of policy adoption during this period. Based on previous research suggesting that half of all smokers die from smoking, we also derived the estimated smoking-attributable deaths (SADs) averted due to MPOWER policy implementation. The results from use of this simple yet powerful method are consistent with those predicted by using previously validated SimSmoke models. FINDINGS In total, 41 countries adopted at least one highest-level MPOWER policy between 2007 and 2010. As a result of all policies adopted during this period, the number of smokers is estimated to have dropped by 14.8 million, with a total of 7.4 million SADs averted. The largest number of SADs was averted as a result of increased cigarette taxes (3.5 million), smoke-free air laws (2.5 million), health warnings (700,000), cessation treatments (380,000), and bans on tobacco marketing (306,000). CONCLUSION From 2007 to 2010, 41 countries and territories took action that will collectively prevent nearly 7.5 million smoking-related deaths globally. These findings demonstrate the magnitude of the actions already taken by countries and underscore the potential for millions of additional lives to be saved with continued adoption of MPOWER policies.

Medical Mistrust Influences Black Women’s Level of Engagement in BRCA1/2 Genetic Counseling and Testing

Clinical evidence supports the value of BRCA1/2 genetic counseling and testing for managing hereditary breast and ovarian cancer risk; however, BRCA1/2 genetic counseling and testing are underutilized among black women, and reasons for low use remain elusive. We examined the potential influence of sociocultural factors (medical mistrust, concerns about genetic discrimination) on genetic counseling and testing engagement in a sample of 100 black women at increased risk for carrying a BRCA1/2 mutation. Eligible participants fell into 1 of 3 groups: (1) healthy women with at least 1 first-degree relative affected by breast and/or ovarian cancer, (2) women diagnosed with breast cancer at age less than or equal to 50 years; and (3) women diagnosed with breast and/or ovarian cancer at age greater than or equal to 50 years with either 1 first-degree relative or 2 second-degree relatives with breast and/or ovarian cancer. Participants were recruited from clinical anid community settings and completed a semistructured interview. Study variable relationships were examined using bivariate tests and multivariate regression analysis. As expected, genetic counseling and testing engagement among this sample was low (28%). After accounting for;sociodemographic factors and self-efficacy (beta=0.37, p<.001), women with higher medical mistrust had lower genetic counseling and testing engagement (beta=-0.26, p<.01). Community-level and individual interventions are needed to improve utilization of genetic counseling and testing among underserved women. Along with trust building between patients and providers, strategies should enhance womens personal confidence. The impact of medical mistrust on the realization of the benefits of personalized medicine in minority populations should be further examined in future studies.

Parental smoking exposure and adolescent smoking trajectories.

OBJECTIVE: In a multigenerational study of smoking risk, the objective was to investigate the intergenerational transmission of smoking by examining if exposure to parental smoking and nicotine dependence predicts prospective smoking trajectories among adolescent offspring. METHODS: Adolescents (n = 406) ages 12 to 17 and a parent completed baseline interviews (2001–2004), and adolescents completed up to 2 follow-up interviews 1 and 5 years later. Baseline interviews gathered detailed information on parental smoking history, including timing and duration, current smoking, and nicotine dependence. Adolescent smoking and nicotine dependence were assessed at each time point. Latent Class Growth Analysis identified prospective smoking trajectory classes from adolescence into young adulthood. Logistic regression was used to examine relationships between parental smoking and adolescent smoking trajectories. RESULTS: Four adolescent smoking trajectory classes were identified: early regular smokers (6%), early experimenters (23%), late experimenters (41%), and nonsmokers (30%). Adolescents with parents who were nicotine-dependent smokers at baseline were more likely to be early regular smokers (odds ratio 1.18, 95% confidence interval 1.05–1.33) and early experimenters (odds ratio 1.04, 95% confidence interval 1.04–1.25) with each additional year of previous exposure to parental smoking. Parents’ current non-nicotine–dependent and former smoking were not associated with adolescent smoking trajectories. CONCLUSIONS: Exposure to parental nicotine dependence is a critical factor influencing intergenerational transmission of smoking. Adolescents with nicotine-dependent parents are susceptible to more intense smoking patterns and this risk increases with longer duration of exposure. Research is needed to optimize interventions to help nicotine-dependent parents quit smoking early in their children’s lifetime to reduce these risks.

Dissemination 2.0: Closing the Gap Between Knowledge and Practice With New Media and Marketing

Despite substantial investments in public health and clinical research at the national level, and significant advancements in these areas of science, few evidence-based programs and services are rapidly implemented in health care or public health practice as a result of failures of dissemination. A significant gap in current processes to disseminate and implement effective programs relates to the lack of systems and infrastructure to facilitate distribution of scientific research products to potential end users, including clinicians and other practitioners. In this article, the authors assert that Web 2.0 technologies can be leveraged to enhance dissemination efforts and increase the implementation of evidence-based programs and services in everyday practice. The authors describe the research-to-practice delivery process and highlight gaps in the supply chain necessary to translate research findings into evidence-based practice. The authors critically evaluate the 4 most prominent strategies currently used to promote dissemination and implementation of research evidence in practice, and they detail how each can be improved by leveraging Web 2.0 technologies to enhance dissemination of research evidence. Last, the authors provide examples and suggestions for capitalizing on Web 2.0 technologies to enhance dissemination efforts and ensure that evidence-based research products reach intended end users and are implemented in clinical practice.

Alcohol-Related Risk Behaviors and Sports Participation Among Adolescents : An Analysis of 2005 Youth Risk Behavior Survey Data

Using 2005 Youth Risk Behavior Survey data, we examined alcohol-related behaviors among adolescent sports participants. Male sports participants were more likely to report heavy drinking and driving after drinking in the past month. Females were less likely to report ever drinking, early drinking, and drinking in the past month.

Social marketing at the right place and right time with new media

Purpose – The purpose of this paper is to seek to discuss how the new media revolution can improve social marketing by bringing the “place” (one of four Ps from the marketing mix) closer to the consumer.Design/methodology/approach – This paper describes current new media trends related to social media and mobile communication technologies and discusses the implications of these technologies for social marketing by exploring examples of their use in commercial marketing, social change, and public health.Findings – The rapid growth of online social networks and near ubiquity of mobile phones in much of the world offers social marketers enormous potential for engaging consumers in radically new ways. The nature of these new communication platforms differs from traditional media in important ways that can make them more effective for marketing, most notably the potential for deeper consumer engagement, multi‐directional information exchange, and location‐based tracking and messaging.Practical implications – ...