Maria-João Alvarez

Formative research on HAPA model determinants for fruit and vegetable intake: target beliefs for audiences at different stages of change

Theoretically driven health communications are needed to promote fruit and vegetable intake among people at different stages of change. The Health Action Process Approach, a clearly specified model and good predictor of fruit and vegetable intake, was used as a framework to guide a formative research for the development of health messages targeting individuals at either a non-intentional or intentional stage of change. A mixed-method approach was used, combining eight focus groups (n = 45) and a questionnaire (n = 390). Target beliefs for people at both stages were identified under five theoretical constructs (risk perception, outcome expectancies, action planning, coping planning and self-efficacy). Highlighting health problems due to low fruit and vegetable consumption, health benefits, weight reduction and pleasure and enhancing self-efficacy to increase fruit and vegetable intake are the main guidelines for designing messages to non-intenders. For intenders, messages should reassure them of their ability to maintain adequate fruit and vegetable consumption, outline specific plans for increased consumption, identify barriers such as preparation, forgetting or being tired and unwilling to eat fruits and vegetables and suggest strategies to overcome them, such as presenting some practical examples on how to include fruits and vegetables when eating out.

Preparatory Behavior for Condom Use Among Heterosexual Young Men A Longitudinal Mediation Model

Objective. Motivation is not sufficient to actually use condoms, as self-regulatory processes are needed to translate motivation into action. Buying condoms and carrying them constitute preparatory behaviors that may serve as proximal predictors of action. Whether or not such preparatory behaviors operate as mediators between intention and action within a broader behavior change framework has been examined. Method. A sample of 150 heterosexual men between ages 18 and 25 years responded at three points in time to a computer-based survey that assessed behavior as well as social-cognitive antecedents. A structural equation model was specified that included preparatory behaviors and self-efficacy as mediators at Time 2. Results. Preparatory behaviors were the most proximal predictors of condom use, and they were, themselves, predicted by self-efficacy and intention. The latter was partly determined by positive emotional outcome expectancies. Conclusion. To bridge the intention-behavior gap, preparatory behaviors play a mediating role, and they represent a side of planning that constitutes the most proximal predictor of condom use.

Health messages to promote fruit and vegetable consumption at different stages: A match-mismatch design

Objective: To examine the effectiveness of matching health messages promoting fruit and vegetable intake to the Health Action Process Approach stages of change. Design: In a randomised controlled trial, 205 undergraduate students (non-intenders n = 123; intenders n = 82) were exposed to one of three health messages, targeted at non-intenders, intenders and controls. Main outcome measures: Three longitudinal assessments of stage, fruit and vegetable intake, and social-cognitive determinants were obtained. Results: Stage-specific effects of the interventions were confirmed. For self-efficacy, a stage by health message crossover interaction emerged, with both non-intenders and intenders in the matched conditions scoring higher in self-efficacy. Furthermore, in line with predictions, non-intenders in the matched condition showed higher risk perception, outcome expectancies, intention, and stage progression immediately after message exposure, and lower levels of action planning and coping planning a week later in the mismatched condition, but for these outcomes no differences across conditions were obtained among intenders. Multiple mediation analyses confirmed the facilitating role of self-efficacy and behavioural intention among non-intenders. Conclusions: Stages should be considered when designing health messages, although more interactive interventions for intenders and extended measurement time frames may be required.

Condom Inclusion in Cognitive Representations of Sexual Encounters

To identify the inclusion of condom use (N = 360 college students), two sexual scripts (stable and casual relationships) were identified by free-generation methods (Study 1) and used to develop open-ended narratives up to the point before sexual intercourse. Participants completed the narratives to verify whether they spontaneously included references to condom use, and these references were related to self-report of sexual protection (Study 2). Finally, a recognition memory test clarified the typicality of condom use actions in the sexual script-based narratives (Study 3). The results indicated that although moderately referred to when free-generation is used, condom use is much less mentioned when participants complete script-based narratives and is considered a script-atypical action. Thus, we conclude that when behavior is guided by script, protective behaviors will not become mentally accessible and will not be used. Both relationships require intervention in order to increase condom use and make it a sexual routine.

Cognitive and Contextual Variables in Sexual Partner and Relationship Perception

This study examined the effects of contextual and cognitive variables for sexual protection on perceived social relationship factors. University students (108 women and 108 men) read script-based narratives on sexual encounters in which six variables were manipulated in two independent analyses. In the first analysis, four variables were evaluated: relational context (stable, casual), condom use (yes, no), script terminus (beginning, middle or end), and the rater’s sex. The dependent variables were interpersonal perception of one of the characters of the narrative, and expectations regarding characteristics and future of the relationship. In the second analysis, two other factors were manipulated only in the “yes” condom conditions: communication strategy (verbal, non-verbal) and condom proponent gender. Our findings corroborated other studies where condom use was viewed as unromantic with less positive characteristics for relationships. Condom proponents, especially male, were perceived as less romantic, particularly when proposing a condom non-verbally at the beginning of the encounter. However, the controlled variables enabled us to propose ways of associating condom use with positive expectations towards the proponent and the relationship itself. Romanticism, expectation of sexual intercourse, emotional proximity, and expectations of condom use in encounters where a condom was proposed increased when suggested by a woman, postponed to the end of the encounter, and verbally mentioned. We encourage women to take the lead in suggesting condom use, thus empowering them since they do not have to wait for the male to make the first move.

A Dyadic Approach to Understanding the Link Between Sexual Functioning and Sexual Satisfaction in Heterosexual Couples

Researchers have demonstrated that several dimensions of sexual functioning (e.g., sexual desire, arousal, orgasm) are associated with the sexual satisfaction of individuals in a committed mixed-sex (male–female) relationship. We extended this research by comparing a dyadic model that included both own (i.e., actor effect) and partner (i.e., partner effect) domains of sexual functioning to an individual model that included only actor effects. Participants were 124 mixed-sex couples who completed online measures of sexual functioning and sexual satisfaction. Data analysis using the actor–partner interdependence model (APIM) and structural equation modeling (SEM) indicated that the dyadic model had a better fit than the individual model. Women’s sexual desire and orgasm and men’s erectile functioning were significant positive predictors of both own and partner’s sexual satisfaction. These results are discussed in terms of the importance of taking a dyadic approach to research and clinical work related to sexual satisfaction.

Stage-Based Computer-Delivered Interventions to Increase Condom Use in Young Men

ABSTRACT Objectives: The aim is to examine whether adopting or increasing condom use can be influenced by psychological treatment targeting both motivational and volitional aspects, when these components are matched to the characteristics of the recipients. Method: In a randomized controlled trial, 159 heterosexual young men (intervention groups, n = 113; control condition, n = 46) were exposed to 2 computer-delivered intervention arms, 1 targeting nonintenders (n = 36; motivational intervention arm) and the other targeting intenders (n = 77; volitional intervention arm). Intention and condom use were assessed through self-report questions at 3 points in time, each 2 weeks apart. Motivational intervention involved screen content requesting decisional balance for condom use and focus on past success to trigger self-efficacy. Volitional intervention encouraged the formation of specific if-then plans, where participants were required to choose and write about the most favourable situations by means of reflection on when, where, and how to carry them out, and of thinking about strategies for obstacles that might hinder condom use. Results: Experimental nonintenders obtained higher levels of condom use intention two weeks and one month later and of reported condom use one month later than control nonintenders. Experimental intenders reported an increase in condom use in comparison with control intenders one month later. Conclusions: At a 30-day follow-up, treatment was shown to have helped nonintenders to first increase their condom use intentions and later condom use, and intenders to improve condom use behavior. A stage-based computer-delivered intervention design including motivational and volitional treatment appears to be suitable for improving condom use motivation as well as behavior after a 1-month period.

Validation and invariance across gender of the Beliefs About Appearance Scale (BAAS) in a community sample of heterosexual adults in a committed relationship

OBJECTIVE To evaluate the psychometric properties of the Beliefs About Appearance Scale (BAAS) in terms of its factorial structure and invariance, reliability, and validity when applied to adults from the community. METHODS Participants consisted of 810 heterosexual Portuguese individuals in a committed relationship. As a confirmatory factor analysis did not support the original structure of the BAAS, an exploratory factor analysis was performed. RESULTS A 12-item version was extracted comprising two dimensions: one personal and the other social. The factorial model depicting this bidimensional structure revealed an adequate fit following confirmatory factor analysis. Multigroup confirmatory factor analyses indicated invariance across gender. Concurrent and discriminant validities and internal consistency were estimated and observed to be adequate. CONCLUSIONS This shorter measure of the BAAS can accurately assess body appearance beliefs and may be used in different research settings and contexts.

When Is Congruency Helpful? Interactive Effects of Frame, Motivational Orientation, and Perceived Message Quality on Fruit and Vegetable Consumption

Health messages framed to be congruent with people’s motivational orientation have been shown to be generally effective in promoting health behavior change, but some inconsistencies have been found. This study tested whether the perceived quality of a health message moderated the congruency effect in the domain of fruit and vegetable (FV) consumption. Undergraduate participants (N = 109) read a health message promoting FV intake in which the frame (gain vs. loss) was either congruent or incongruent with their approach/avoidance motivational orientation. Perceived message quality and intention to increase FV intake were assessed after message exposure, and self-reported FV intake was assessed one week later. A significant interaction between congruency and perceived message quality was found on both intention and FV intake. When messages were congruent, higher intentions and FV intake were observed when perceived message quality was high, but the reverse pattern was observed when perceived message quality was low. The findings support the potential utility of using congruently-framed messages to promote fruit and vegetable consumption, while also underscoring the necessity of using high-quality messages in order for congruency to influence health-related behaviors.

Psychological, behavioral, and clinical effects of intra-oral camera: a randomized control trial on adults with gingivitis

OBJECTIVES To evaluate the effects of using an intra-oral camera (IOC) during supportive periodontal therapy (SPT), on the psychological, behavioral, and clinical parameters of patients with gingivitis, outlined by evidence and a theory-based framework. METHODS A group of 78 adult patients with gingivitis receiving an SPT was randomized into two groups: IOC and control. Bleeding on Marginal Probing (BOMP), self-reported dental hygiene behaviors, and psychological determinants of behavior change (outcome expectancies, self-efficacy, and planning) and IOC opinion were evaluated 1 week before or during the appointment and 4 months later. Repeated-measures anova was used to compare groups over time. RESULTS Almost all the patients brushed their teeth daily, while 78% either never or hardly ever used dental floss. The IOC group showed significant improvements in BOMP index (P < 0.001), self-reported flossing (P < 0.05), and self-efficacy (P < 0.05) compared to the control group. CONCLUSIONS The use of IOC significantly improves clinical, behavioral, and psychological determinants of periodontal health 4 months after treatment.