Rachel Povey

Attitudes towards following meat, vegetarian and vegan diets: an examination of the role of ambivalence

Vegetarianism within the U.K. is growing in popularity, with the current estimate of 7% of the population eating a vegetarian diet. This study examined differences between the attitudes and beliefs of four dietary groups (meat eaters, meat avoiders, vegetarians and vegans) and the extent to which attitudes influenced intentions to follow each diet. In addition, the role of attitudinal ambivalence as a moderator variable was examined. Completed questionnaires were obtained from 111 respondents (25 meat eaters, 26 meat avoiders, 34 vegetarians, 26 vegans). In general, predictions were supported, in that respondents displayed most positive attitudes and beliefs towards their own diets, and most negative attitudes and beliefs towards the diet most different form their own. Regression analyses showed that, as predicted by the Theory of Planned Behaviour, attitudes, subjective norm and perceived behavioural control were significant predictors of intention to follow each diet (apart from the vegetarian diet, where subjective norm was non-significant). In each case, attitudinal ambivalence was found to moderate the attitude-intention relationship, such that attitudes were found to be stronger predictors at lower levels of ambivalence. The results not only highlight the extent to which such alternative diets are an interesting focus for psychological research, but also lend further support to the argument that ambivalence in an important influence on attitude strength.

Ambivalence about health-related behaviours: An exploration in the domain of food choice.

OBJECTIVES Interest in attitudes and ambivalence has highlighted problems with the adequacy of conceptualizing attitudes as unitary, unidimensional, evaluations. In this paper, we report an application of the Theory of Planned Behaviour (Ajzen, 1991) in the domain of dietary choice which investigates the hypothesis that ambivalence will attenuate observed attitude-intention relationships (since the evaluations influencing the expression of attitudes are more likely to differ from the evaluations influencing the expression of intentions for people who are more ambivalent. DESIGN Participants completed a postal questionnaire which contained, inter alia, measures assessing the components of the Theory of Planned Behaviour and a measure of ambivalence. METHODS Participants (N = 296) were recruited via advertisements placed in local newspapers, asking for volunteers to assist in a research project. Participants were randomly assigned to complete a questionnaire about either their chocolate consumption or their meat consumption. Participants were paid 4. RESULTS The findings show considerable support for the hypothesis: there was a tendency for attitude-intention relationships to be attenuated among participants with higher levels of ambivalence, compared to participants with lower levels of ambivalence. CONCLUSIONS The research supports the widespread view that ambivalence is an important issue, both for those involved in basic attitude research and for those who seek to use attitude theories in applied research. In particular, the findings indicate that ambivalence may often have implications for the predictive ability of attitude-intention-behaviour models, especially when applied to health-related behaviours that are characterized by motivational conflicts.

Moderating role of attitudinal ambivalence within the theory of planned behaviour

The present study examined the moderating role of attitudinal ambivalence within the theory of planned behaviour (TPB). Attitude, subjective norm, perceived behavioural control (PBC), behavioural intentions and self-reported behaviour were assessed in relation to 20 healthy eating behaviours in a prospective questionnaire design in 232 members of the general public in the UK. Between-participants univariate and multivariate analyses indicated attitude-behaviour and PBC-behaviour relationships to be weaker in higher ambivalence compared to lower ambivalence respondents. These effects were confirmed in within-participants analyses. The findings are discussed in terms of the role of ambivalence in furthering our understanding of relationships in the TPB.

Promoting children's fruit and vegetable consumption: Interventions using the Theory of Planned Behaviour as a framework

OBJECTIVE This study compared a motivational intervention based on the Theory of Planned Behaviour (TPB) with a volitional intervention based on implementation intentions. DESIGN The study employed a quantitative longitudinal questionnaire design involving two waves of data collection. METHOD Participants (N=198) were randomly allocated to a control group or one of two intervention groups. TPB variables, and fruit and vegetable consumption were assessed at the beginning of the study (time 1) and 2 weeks later (time 2). Experimental group A formed an implementation intention, about how, when and where they could eat five portions a day, whilst experimental group B stated ways they could overcome motivational barriers to eating five portions a day. RESULTS Both interventions were found to increase fruit and vegetable consumption significantly, although only the volitional intervention demonstrated a significant increase in fruit and vegetable consumption over the control intervention. CONCLUSIONS The present study found support for two interventions in increasing fruit and vegetable consumption in children. These findings are encouraging regarding the use of these types of interventions within schools to improve childrens eating behaviour.

Diabetes and Healthy Eating A Systematic Review of the Literature

PURPOSE The purpose of this study is to review the literature on healthy eating interventions within diabetes care. DATA SOURCES The databases PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO were searched for the terms healthy eating or dietary and intervention and diabetes in the abstracts. In addition, electronic searches of the contents of Diabetes, Clinical Diabetes, Diabetes Care, Diabetes Spectrum, and Diabetic Medicine were conducted. STUDY SELECTION Articles were included in the review if the participants were diagnosed with type 1 or type 2 diabetes, results from an intervention to promote dietary change were reported, measurements were taken from 2 time points (preintervention and postintervention), at least 1 outcome measured eating behavior, and the articles had been published between 1990 and the present date. DATA EXTRACTION Data were extracted from the 23 studies found to be eligible. Studies were compared in terms of sample types and sizes, duration, and type and content of intervention. DATA SYNTHESIS Comparisons were made between the characteristics of those studies that produced a statistically significant result and those that did not, for the different outcome measures. CONCLUSIONS For studies measuring the outcomes of weight, fat intake, saturated fat intake, and carbohydrates, there was a tendency for successful interventions to include an exercise dimension and group work. Some outcomes had a tendency to show significant changes in studies of longer duration (eg, serum cholesterol), whereas others were more likely to show significant changes in studies of shorter duration (eg, weight, fiber), suggesting that certain outcomes may be more difficult to maintain. Future research would benefit by ensuring that sample sizes are adequate to give sufficient power, and interventions should be designed that focus on the maintenance in addition to the initiation of eating behavior change.

A systematic review of the effectiveness of smartphone applications that encourage dietary self-regulatory strategies for weight loss in overweight and obese adults

The aim of this paper is to systematically review the evidence to explore whether smartphone applications that use self‐regulatory strategies are beneficial for weight loss in overweight and obese adults over the age of 18 years. Sixteen electronic databases were searched for articles published up to April 2015 including MEDLINE, OVID, Ingenta, PSYCARTICLES and PSYCINFO, CINAHL, Sportdiscus, Science Direct, Web of Knowledge, Cochrane Library, JSTOR, EBSCO, Proquest, Wiley and Google Scholar. Twenty nine eligible studies were retrieved of which six studies met the inclusion criteria. Studies that recruited participants under the age of 18 years, adults with a chronic condition or did not report weight loss outcomes were excluded. Study findings were combined using a narrative synthesis. Overall, evidence suggests that smartphone applications may be a useful tool for self‐regulating diet for weight loss as participants in the smartphone application group in all studies lost at least some bodyweight. However, when compared to other self‐monitoring methods, there was no significant difference in the amount of weight lost. Findings should be interpreted with caution based on the design of the studies and the comparator groups used. Future research needs to be more methodologically rigorous and incorporate measures of whether eating habits become healthier in addition to measuring weight and BMI.

Predicting women's intentions to use pain relief medication during childbirth using the Theory of Planned Behaviour and Self‐Efficacy Theory

Womens use of pain relief strategies during childbirth can be predicted to an extent by their prior intentions to use the strategy, although how women arrive at their intentions is currently unclear. This study investigated whether antenatal beliefs about pharmacological and non‐pharmacological pain management strategies predicted womens intentions to use Entonox (NO2&O2), pethidine, and epidural analgesia during childbirth. A self‐selected sample of 100 women in the third trimester of pregnancy completed a questionnaire containing belief‐based measures of the attitude, subjective norm, and perceived behavioural control components of the Theory of Planned Behaviour (TPB) for each medication, and the Childbirth Self‐Efficacy Inventory. Pharmacological beliefs as assessed by the TPB significantly predicted intentions to use all three medications. Subjective norm independently predicted intentions to use all three medications. Attitude predicted intentions to use NO2&O2 and epidural analgesia and perceived behavioural control predicted intentions to use pethidine alone. Beliefs about non‐pharmacological pain management strategies as assessed by self‐efficacy theory did not significantly enhance the prediction of intentions to use any of the medications. The findings suggest that targeting pharmacological beliefs during antenatal education will impact most upon womens intentions to use analgesia during childbirth.

The experiences and understandings of obesity: families' decisions to attend a childhood obesity intervention.

Objectives: This study investigated the families’ experiences of a childhood obesity intervention and sought to understand factors that influence attendance and lifestyle behaviours. Design: Eleven semi-structured interviews were conducted and analysed using Interpretative Phenomenological Analysis. Results: Four themes emerged highlighting the differences and similarities between attendees and non-attendees perceptions of childhood obesity, perceptions of the intervention, practical barriers and overcoming hurdles to attending and, availability and suitability of local facilities. Conclusions: The findings relate to identity and health communication. For some families attending an obesity intervention may challenge social and individual identities, which may have an impact on subsequent behavioural decisions. Those who attend the obesity intervention may experience a shift in identity, which may or may not initially be perceived as a positive outcome. Public Health and those involved in treatment interventions should aim to bridge the gap between people’s in-group identities and those associated with particular lifestyle behaviours. In order to be effective, services must meet the needs of their clients and address any preconceived negative perceptions by carefully considering how health information is presented, how it is understood and most importantly how identity may affect motivation to engage in, and sustain, new behaviours.

Patients’ and Practitioners’ Views on Health Behaviour Change: A Qualitative Study

Objective This study was designed to examine patients’ and health professionals’ perspectives on lifestyle behaviour change and to inform the development of a lifestyle behaviour change intervention to be used in primary care. Design Focus groups were conducted with seven patients and 13 health professionals where they were asked to discuss lifestyle behaviour change in relation to the design and development phase of a tailored lifestyle behaviour change intervention package. Results An inductive thematic analysis of transcripts suggested a range of issues that are relevant to the development and implementation of lifestyle change interventions such as time, lack of resources and starting interventions too late, as well as personal circumstances and the continuous effort that behaviour change requires. They were interpreted as two superordinate themes of ‘internal and external influences on behaviour change’ and ‘behaviour change initiation and maintenance’. The results are discussed in relation to the implications they may have for researchers and health service commissioners designing interventions and practitioners implementing lifestyle change interventions in primary care. Conclusion Many factors are involved in patients’ and health care professionals’ understanding of interventions and lifestyle behaviour change. These should be taken into consideration when designing interventions based on behaviour change theories.

Assessing interventions to increase compliance to patching treatment in children with amblyopia: a systematic review and meta-analysis

Background/Aims Amblyopia is the most common condition affecting visual acuity in childhood. Left untreated it will not resolve itself, leading to increased risk of blindness. Occluding the good eye with a patch is a highly effective treatment if carried out before age 7 years but compliance is a major problem. This systematic review addresses the question: How effective are existing interventions at increasing compliance to patching treatment in children with amblyopia? Methods Electronic searches were carried out in June 2014 and updated in April 2015 to identify studies reporting primary data on interventions to increase patching compliance. Data screening, extraction and quality ratings were performed independently by two researchers. Results Nine papers were included. Interventions including an educational element (5 studies) significantly increased patching compliance and had higher quality ratings than interventions that changed aspects of the patching regime (3 studies) or involved supervised occlusion (1 study). Meta-analysis was conducted on four studies and indicated that overall interventions involving an educational element have a significant small effect r=0.249, p<0.001. Conclusions Interventions to increase patching compliance should include educational elements. High quality research is needed to further assess the effectiveness of specific elements of educational interventions and additional behaviour change techniques.