Lydi-Anne Vézina-Im

Psychosocial determinants of fruit and vegetable intake in adult population: a systematic review

BackgroundAccumulating 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.MethodsPublished 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.ResultsA 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.ConclusionsOur 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.

Determinants of physical activity maintenance: a systematic review and meta-analyses

Abstract 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 adjusted R 2 [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.

The effect of theory-based interventions on physical activity participation among overweight/obese individuals: a systematic review

Little attention has been paid to the evaluation of the long‐term impact of theory‐based interventions on physical activity participation among overweight/obese individuals after the interventions have ended. The primary aim of this systematic review was to investigate the long‐term effectiveness of theory‐based interventions increasing physical activity and identify the most effective techniques for behaviour change among overweight/obese individuals. The secondary aim was to investigate the effect of these interventions on theoretical variables. Eighteen studies were reviewed. Among these studies, three reported significant short‐term and two long‐term effects of interventions on physical activity participation. Most of the studies observed a significant short‐ or long‐term effect of time on this behaviour. Theoretical frameworks most often applied included the Behavioural Model and the Social Learning/Cognitive Theory. However, few of the studies reported any impact on theoretical variables. The most prevalent techniques consisted of providing opportunities for social comparison and instruction as well as self‐monitoring. Leading techniques differentiating the experimental group from the control group included prompting practice and intentions formation and barriers identification. Although the combination of these three techniques appears successful, the long‐term impact of theory‐based interventions remains ambiguous.

Efficacy of Interventions Promoting Blood Donation: A Systematic Review

Findings about the efficacy of interventions promoting blood donation are scattered and sometime inconsistent. The aim of the present systematic review was to identify the most effective types of interventions and modes of delivery to increase blood donation. The following databases were investigated: MEDLINE/PubMed, PsycINFO, CINAHL, EMBASE, and Proquest Dissertations and Theses. Additional studies were also included by checking the references of the articles included in the review and by looking at our personal collection. The outcomes of interest were either blood drive attendance or blood donations. A total of 29 randomized controlled trials or quasi-experimental studies were included in the review, detailing 36 interventions tested among independent samples. Interventions targeting psychosocial cognitions (s = 8, s to represent the number of independent samples; odds ratio [OR], 2.47; 95% confidence interval [CI], 1.42-4.28), those stressing the altruistic motives to give blood (s = 4; OR, 3.89; 95% CI, 1.03-14.76), and reminders (s = 7; OR, 1.91; 95% CI, 1.22-2.99) were the most successful in increasing blood donation. The results suggest that motivational interventions and reminders are the most effective in increasing blood donation, but additional studies are needed to evaluate the efficacy of other types of interventions.

Question–behaviour effect: A randomised controlled trial of asking intention in the interrogative or declarative form

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.

Motivations of physicians and nurses to practice voluntary euthanasia: a systematic review

BackgroundWhile a number of reviews have explored the attitude of health professionals toward euthanasia, none of them documented their motivations to practice euthanasia. The objective of the present systematic review was to identify physicians’ and nurses’ motives for having the intention or for performing an act of voluntary euthanasia and compare findings from countries where the practice is legalized to those where it is not.MethodsThe following databases were investigated: MEDLINE/PubMed (1950+), PsycINFO (1806+), CINAHL (1982+), EMBASE (1974+) and FRANCIS (1984+). Proquest Dissertations and Theses (1861+) was also investigated for gray literature. Additional studies were included by checking the references of the articles included in the systematic review as well as by looking at our personal collection of articles on euthanasia.ResultsThis paper reviews a total of 27 empirical quantitative studies out of the 1 703 articles identified at the beginning. Five studies were in countries where euthanasia is legal and 22 in countries where it is not. Seventeen studies were targeting physicians, 9 targeted nurses and 1 both health professionals. Six studies identified the motivations underlying the intention to practice euthanasia, 16 the behavior itself and 5 both intention and behavior. The category of variables most consistently associated with euthanasia is psychological variables. All categories collapsed, the four variables most frequently associated with euthanasia are past behavior, medical specialty, whether the patient is depressed and the patient’s life expectancy.ConclusionsThe present review suggests that physicians and nurses are motivated to practice voluntary euthanasia especially when they are familiar with the act of euthanasia, when the patient does not have depressive symptoms and has a short life expectancy and their motivation varies according to their medical specialty. Additional studies among nurses and in countries where euthanasia is legal are needed.

Efficacy of school-based interventions aimed at decreasing sugar-sweetened beverage consumption among adolescents: a systematic review

OBJECTIVE To verify the efficacy of school-based interventions aimed at reducing sugar-sweetened beverage (SSB) consumption among adolescents in order to develop or improve public health interventions. DESIGN Systematic review of interventions targeting adolescents and/or the school environment. SETTING The following databases were investigated: MEDLINE/PubMed, PsycINFO, CINAHL and EMBASE. Proquest Dissertations and Theses was also investigated for unpublished trials. SUBJECTS Adolescents were defined as individuals between the ages of 12 and 17 years. RESULTS A total of thirty-six studies detailing thirty-six different interventions tested among independent samples (n 152 001) were included in the review. Twenty interventions were classified as educational/behavioural and ten were classified as legislative/environmental interventions. Only six interventions targeted both individuals and their environment. Over 70 % of all interventions, regardless of whether they targeted individuals, their environment or both, were effective in decreasing SSB consumption. Legislative/environmental studies had the highest success rate (90·0 %). Educational/behavioural interventions only and interventions that combined educational/behavioural and legislative/environmental approaches were almost equally effective in reducing SSB consumption with success rates of 65·0 and 66·7 %, respectively. Among the interventions that had an educational/behavioural component, 61·5 % were theory-based. The behaviour change techniques most frequently used in interventions were providing information about the health consequences of performing the behaviour (72·2 %), restructuring the physical environment (47·2 %), behavioural goal setting (36·1 %), self-monitoring of behaviour (33·3 %), threat to health (30·6 %) and providing general social support (30·6 %). CONCLUSIONS School-based interventions show promising results to reduce SSB consumption among adolescents. A number of recommendations are made to improve future studies.

Psychosocial determinants of physicians’ intention to practice euthanasia in palliative care

BackgroundEuthanasia remains controversial in Canada and an issue of debate among physicians. Most studies have explored the opinion of health professionals regarding its legalization, but have not investigated their intentions when faced with performing euthanasia. These studies are also considered atheoretical. The purposes of the present study were to fill this gap in the literature by identifying the psychosocial determinants of physicians’ intention to practice euthanasia in palliative care and verifying whether respecting the patient’s autonomy is important for physicians.MethodsA validated anonymous questionnaire based on an extended version of the Theory of Planned Behavior was mailed to a random sample of 445 physicians from the province of Quebec, Canada.ResultsThe response rate was 38.3% and the mean score for intention was 3.94 ± 2.17 (range: 1 to 7). The determinants of intention among physicians were: knowing patients’ wishes (OR = 10.77; 95%CI: 1.33-86.88), perceived behavioral control—physicians’ evaluation of their ability to adopt a given behavior—(OR = 4.35; 95%CI: 1.44-13.15), moral norm—the appropriateness of adopting a given behavior according to one’s personal and moral values—(OR = 3.22; 95%CI: 1.29-8.00) and cognitive attitude—factual consequences of the adoption of a given behavior—(OR = 3.16; 95%CI: 1.20-8.35). This model correctly classified 98.8% of physicians. Specific beliefs that might discriminate physicians according to their level of intention were also identified. For instance, physicians’ moral norm was related to the ethical principle of beneficence.ConclusionsOverall, physicians have weak intentions to practice euthanasia in palliative care. Nevertheless, respecting patients’ final wishes concerning euthanasia seems to be of particular importance to them and greatly affects their motivation to perform euthanasia.

Organ and tissue donation in clinical settings: a systematic review of the impact of interventions aimed at health professionals

In countries where presumed consent for organ donation does not apply, health professionals (HP) are key players for identifying donors and obtaining their consent. This systematic review was designed to verify the efficacy of interventions aimed at HPs to promote organ and tissue donation in clinical settings. CINAHL (1982 to 2012), COCHRANE LIBRARY, EMBASE (1974 to 2012), MEDLINE (1966 to 2012), PsycINFO (1960 to 2012), and ProQuest Dissertations and Theses were searched for papers published in French or English until September 2012. Studies were considered if they met the following criteria: aimed at improving HPs’ practices regarding the donation process or at increasing donation rates; HPs working in clinical settings; and interventions with a control group or pre-post assessments. Intervention behavioral change techniques were analyzed using a validated taxonomy. A risk ratio was computed for each study having a control group. A total of 15 studies were identified, of which only 5 had a control group. Interventions were either educational, organizational or a combination of both, and had a weak theoretical basis. The most common behavior change technique was providing instruction. Two sets of interventions showed a significant risk ratio. However, most studies did not report the information needed to compute their efficacy. Therefore, interventions aimed at improving the donation process or at increasing donation rates should be based on sound theoretical frameworks. They would benefit from more rigorous evaluation methods to ensure good knowledge translation and appropriate organizational decisions to improve professional practices.

The effects of a phone call prompt on subsequent blood donation among first-time donors

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.