Fiona Mowbray

Ticking All the Boxes? A Systematic Review of Education and Communication Interventions to Prevent Tick-Borne Disease

Tick-borne disease has become increasingly prevalent across Europe. Despite the effectiveness of protective behaviors, relatively few people adopt them when in areas where ticks are known to be present. In this systematic review we identified studies that assessed the impact of any educational or behavioral interventions intended to encourage the widespread use of protective behaviors against tick-borne disease. An extensive search of electronic databases returned a total of only nine such studies. Only two of these were fully randomized controlled trials, with the remaining studies using weaker designs and often relying solely on self-reports to assess behavior. The majority of research in this area has not explicitly noted the consideration of any formal psychological theory on how best to promote behaviors that protect health. Nonetheless, the results show that both knowledge of and attitudes towards tick-borne disease are amenable to change, although the stability of these changes over time has not yet been determined. Not all intervention strategies have proved effective, with some producing detrimental effects. More theory-based, methodologically-robust studies are urgently required if we are to gain a better understanding of the most effective strategies for encouraging members of the public to adopt behaviors known to protect against tick-borne disease.

Predictors of protective behaviour against ticks in the UK: A mixed methods study

The objective of this research was to determine the most appropriate protective behaviours to promote in order to protect members of the public from Lyme borreliosis, to identify the drivers and barriers for these behaviours, and to determine the strongest predictors of tick-protective behaviour. We used a mixed methods study with qualitative interviews and a quantitative web survey. Interviews with topic experts and members of the public suggested that predictors of tick checking included perceived disease likelihood and severity as well as overall awareness of ticks and tick-borne disease. Twenty-four percent of participants regularly checked for ticks after walking in a tick-endemic area. The strongest predictors of checking for ticks were greater levels of knowledge, perceived likelihood of being bitten, self-efficacy about tick removal, and lower levels of disgust about ticks. Barriers to checking included forgetfulness and lacking time. At-risk members of the UK public require information to increase awareness of ticks and protective behaviours, particularly tick checking. Information may be most effective if it focuses on increasing self-efficacy while also reducing disgust.

Communicating to increase public uptake of pandemic flu vaccination in the UK: which messages work?

BACKGROUND Vaccination is considered the most effective preventive measure against influenza transmission, yet vaccination rates during the 2009/10 influenza A/H1N1 pandemic were low across the world, with the majority of people declining to receive the vaccine. Despite extensive research on the predictors of uptake of influenza vaccination, little research has focused on testing the effectiveness of evidence and theory-based messages. AIMS To examine the persuasiveness of messages promoting vaccination and antiviral use either as health-enhancing or as risk-reducing, as well as messages which conveyed evidence-based information about the costs and benefits of vaccination, or which applied anticipated regret as a motivator for vaccine uptake. METHOD We conducted 11 focus groups with forty-one members of the general population in England including young and older adults, those with lower education, parents, and those with elevated health risk. The data were analysed using thematic analysis. RESULTS The factual, evidence-based messages were well received with participants finding them the most convincing and useful, particularly where they gave cost-benefit comparisons. Health-enhancing messages were received with scepticism and concern that the messages were not honest about the potential lack of safety of vaccination. In contrast, risk-reduction messages were perceived as being more balanced and credible. Messages aiming to elicit feelings of anticipated regret for not getting vaccinated were generally perceived as patronising and unprofessional. CONCLUSIONS Vaccination messages should be kept brief, but convey balanced, evidence-based information, and be transparent in their communication of potential side-effects. The general public seem to prefer messages that are factual and emphasise the costs and benefits of vaccination, particularly with regards to vaccine safety.

Increasing the intent to receive a pandemic influenza vaccination: Testing the impact of theory-based messages

OBJECTIVE Vaccination is an effective preventive measure to reduce influenza transmission, especially important in a pandemic. Despite the messages encouraging vaccination during the last pandemic, uptake remained low (37.6% in clinical risk groups). This study investigated the effect of different types of messages regarding length, content type, and framing on vaccination intention. METHOD An online experiment was conducted in February 2015. A representative sample of 1424 people living in England read a mock newspaper article about a novel influenza pandemic before being randomised to one of four conditions: standard Department of Health (DoH) (long message) and three brief theory-based messages - an abridged version of the standard DoH and two messages additionally targeting pandemic influenza severity and vaccination benefits (framed as risk-reducing or health-enhancing, respectively). Intention to be vaccinated and potential mediators were measured. RESULTS The shortened DoH message increased vaccination intention more than the longer one, by increasing perceived susceptibility, anticipated regret and perceived message personal relevance while lowering perceived costs, despite the longer one being rated as slightly more credible. Intention to be vaccinated was not improved by adding information on severity and benefits, and the health-enhancing message was not more effective than the risk-reducing. CONCLUSION A briefer message resulted in greater intention to be vaccinated, whereas emphasising the severity of pandemic influenza and the benefits of vaccination did not. Future campaigns should consider using brief theoretically-based messages, targeting knowledge about influenza and precautionary measures, perceived susceptibility to pandemic influenza, and the perceived efficacy and reduced costs of vaccination.

Notification about seasonal influenza vaccination: what is the best way to increase uptake?

Notification about seasonal influenza vaccination: what is the best way to increase uptake?

Evaluating the Content Validity of Four Performance Outcome Measures in Patients with Elective Hip Replacements and Hip Fractures

OBJECTIVES To assess the content validity of performance outcome (PerfO) measures for use with patients undergoing hip fracture (HF) surgery and elective total hip replacement (eTHR). METHODS This study was a substudy of a broader evaluation of measurement properties of PerfO measures. The PerfO measures assessed were timed up and go (TUG), four-step stair climb (4SC), long stair climb (LSC), and repeated chair stand (RCS). For this substudy, HF and eTHR participants were interviewed to evaluate the relevance and difficulty of each PerfO measure. Qualitative analysis was conducted on interview transcripts, and summaries of coded data were produced to assess saturation. RESULTS All 18 HF participants related the PerfO measures (TUG, 4SC, and RSC) to activities they completed in daily life, with slight variations in some specific aspects. For the eight eTHR participants, the correspondence between the PerfO measures (TUG, 4SC, and LSC) and activities in daily life varied: all participants saw similarity in the movements for the TUG; most undertook short stair climbs in daily life, but most did not regularly undertake LSC in daily life. Nevertheless, all HF and eTHR participants reported that the PerfO measures were relevant and had a level of difficulty similar to daily activities. CONCLUSIONS This study contributes novel methods that adapt US regulatory guidance for patient-reported outcome measures to the evaluation of PerfO measures. A structured approach was used to explore specific details of each measure and correspondence to everyday life. This study demonstrates how content validity of PerfO measures can be meaningfully assessed.

Predictors of protective behaviour against ticks in the UK

The objective of this research was to determine the most appropriate protective behaviours to promote in order to protect members of the public from Lyme borreliosis, to identify the drivers and barriers for these behaviours, and to determine the strongest predictors of tick-protective behaviour. We used a mixed methods study with qualitative interviews and a quantitative web survey. Interviews with topic experts and members of the public suggested that predictors of tick checking included perceived disease likelihood and severity as well as overall awareness of ticks and tick-borne disease. Twenty-four percent of participants regularly checked for ticks after walking in a tick-endemic area. The strongest predictors of checking for ticks were greater levels of knowledge, perceived likelihood of being bitten, self-efficacy about tick removal, and lower levels of disgust about ticks. Barriers to checking included forgetfulness and lacking time. At-risk members of the UK public require information to increase awareness of ticks and protective behaviours, particularly tick checking. Information may be most effective if it focuses on increasing self-efficacy while also reducing disgust.

Original articlePredictors of protective behaviour against ticks in the UK: A mixed methods study

The objective of this research was to determine the most appropriate protective behaviours to promote in order to protect members of the public from Lyme borreliosis, to identify the drivers and barriers for these behaviours, and to determine the strongest predictors of tick-protective behaviour. We used a mixed methods study with qualitative interviews and a quantitative web survey. Interviews with topic experts and members of the public suggested that predictors of tick checking included perceived disease likelihood and severity as well as overall awareness of ticks and tick-borne disease. Twenty-four percent of participants regularly checked for ticks after walking in a tick-endemic area. The strongest predictors of checking for ticks were greater levels of knowledge, perceived likelihood of being bitten, self-efficacy about tick removal, and lower levels of disgust about ticks. Barriers to checking included forgetfulness and lacking time. At-risk members of the UK public require information to increase awareness of ticks and protective behaviours, particularly tick checking. Information may be most effective if it focuses on increasing self-efficacy while also reducing disgust.

Risk perception, precautionary behaviour and public health education for tick-borne disease risks

Background: Theorised pathways in an ‘extended’ common-sense model of illness representations (CSM) in those affected by Irritable Bowel Syndrome (IBS) were examined. Analysis contrasted between those using complementary medicines (CAM-users) and those not using CAM (non-users). Methods: A web-based cross-sectional survey. Participants (n=653) were recruited from an IBS self-help network and other online illness discussion forums and assessed on the IPQ-R, the BMQ-General, the Brief-COPE and IBS-QOL. Findings: CAM-users reported poorer quality of life compared to non-users. Stronger perceptions of illness consequences and emotional representations were strongly correlated with reduced quality of life and poorer emotional outcomes in both groups. Self-blame and behavioural disengagement partially mediated the pathway from perception to outcome. Discussion: Findings suggest consistency with CSM theory. The detected influence of representations on quality of life (via coping strategies) suggests health psychologists could address components of illness perceptions to improve quality of life in those affected by IBS.Background: Psychological preparation has been demonstrated to improve post-operative outcomes including pain and health care resource use. This systematic review (registered with the Cochrane Anaesthesia Review Group) will investigate which methods of preparation are effective and for which outcomes. Economic data will be reviewed where available. Methods: Randomised controlled trials (RCTs) of adults undergoing elective surgery under general anaesthesia are included. Papers are identified using electronic searches, reference lists and contact with authors of studies to identify unpublished research. Expected results: In a meta-analysis including 38 RCTs, Johnston and Vogele (1993) found psychological preparation to be effective in improving various postoperative outcomes. It is expected that this up-dated review will provide further evidence about which techniques are effective because more studies are now available. Current stage of work: Papers are being screened for inclusion. Discussion: Identifying effective pre-surgical interventions may result in improved patient outcomes and healthcare resource use.[Extract] Background: Qualities of resilience have been strongly identified within farming populations. This resilience is being challenged, with high suicide rates raising concerns about the mental health of the farming population. This research explored those factors which impacted the resilience of farming families of Australia. Methods: Interviews were conducted (N=53 participants) and analysed using Grounded Theory and Content Analysis. Based on qualitative findings, a subsequent sample (N=278) of farming families from across Australia completed the survey. Measures of stressors, work-life balance, coping, buffering characteristics and well-being were distributed. Findings: Outcomes suggested themes of commitment and identification with farming helped build resilience. Path analysis indicated that buffering characteristics mediated and moderated the impact of stressors and role interference on indicators of well-being, χ² (18)=23.98, p=0.156. Discussion: Recommendations were made for raising awareness to the farming community of the risk factors for poor health and suggestions for increasing the resilience of groups at-risk of poor well-being.Resiliance and Health - 26th Conference of the European Health Psychology Society, Prague, Czech Republic, 21st - 25th August 2012Using two behavioral risk tasks (Balloon Analogue Risk Task BART; Lejuez et al. 2002 and Columbia Card Task, CCT; Figner et al. 2009) that mimic important features of real-world risk taking behaviors, we investigated the effects of different types of negative affect on risk taking. Methods: Participants (N¼50) were first administered the Hospital Anxiety and Depression Scale (HADS; Zigmond et al. 1983). One month later, they completed the BART and the cold CCT, in counterbalanced order. State mood was assessed before participants played the CCT and BART. Findings: Higher levels of anxiety were associated with less risk taking in both tasks; depression was unrelated to risk taking. Hierarchical regression analysis showed that these findings were robust to mood effects. Discussion: Findings from the current study indicated that healthy subjects’ risk taking tendencies vary between anxiety and depression. Implications for prevention of health risks are discussed. 194 EHPS 2012 abstracts Downloaded byBackground: Physical exercise contributes to healthy ageing, and strength training has beenshown to improve independence in older people.Method: Six hundred older people wererandomly selected from ...Background: Conceptual clarification of salutogenesis (Antonovsky 1987) and resilience – what is common and different? Methods: A systematic research synthesis 1992–2010 based on about 1300 papers ...Resiliance and Health - 26th Conference of the European Health Psychology Society, Prague, Czech Republic, 21st - 25th August 2012This conference abstract looks provides an analysis of the behaviour change techniques used in Scottish Government supported behaviour change interventionsBackground: The aim of this research was to examine variables that influence attention to health information in order to develop a predictive model. Methods: Community participants(N=330) were randomly assigned to one of two conditions presenting information about coronary heart disease (CHD) or road accidents. Information was either risk or neutral in valency. Attention to information was measured using a surprise recall task. Other variables measured included perceived risk, optimism, control and coping strategies. Findings: Overall, participants in the CHD condition remembered significantly more risk information than participants in the road condition. Participants in the road condition endorsed significantly lower beliefs in personal control perceptions while also endorsing greater beliefs in other’s control over their own road outcomes. Discussion: While perceived control is usually emphasised as integral in adopting protective behaviours these findings suggest that they are also central in communicating health information.