British Journal of Health Psychology最新文献

Objectives: Appearance concerns following burn injuries are common. Psychological factors are important in maintaining such concerns. However, there is a lack of longitudinal or prospective research investigating their development. This study investigated whether psychological flexibility and self-compassion at hospital admission predicted subsequent appearance concerns.

Design: A multi-centre prospective cohort study across six burn services.

Methods: Adults (n = 175; 67% male) in hospital following burn injuries were recruited. Questionnaires measuring appearance concerns, psychological flexibility, self-compassion, post-traumatic stress disorder symptoms and perceived noticeability were completed during hospital admission and two- and six-months later. Demographic and burn injury information was collected.

Results: Correlational analyses showed that increased psychological flexibility and self-compassion at admission were associated with decreased appearance concerns cross-sectionally and prospectively at two- and six-month follow-up. These associations remained significant when controlling for key covariates (i.e. gender, age, ethnicity, percentage total body surface area burnt, perceived noticeability, PTSD symptoms). Multiple linear regression analyses revealed that psychological flexibility and self-compassion predicted appearance concerns during hospital admission. Although psychological flexibility significantly predicted appearance concerns over time, it became non-significant when controlling for baseline appearance concerns.

Conclusions: Psychological flexibility has a protective role against appearance concerns soon after burn injuries, although this protective role is reduced when accounting for baseline appearance concerns. Early interventions targeting psychological flexibility (i.e. acceptance and commitment therapy) may be beneficial after burns if adapted to address appearance-related concerns.

Objectives: Physical distancing and handwashing can be important infection prevention measures during an infectious disease outbreak such as the COVID-19 pandemic. To stimulate these behaviours, knowledge of psychosocial determinants as well as contextual factors is vital. We present longitudinal, within-person analyses of the impact of contextual and psychosocial factors on handwashing and distancing behaviour.

Design: We used individual-level data (186,490 participants completing 971,899 surveys) from the Corona Behavioural Unit COVID-19 Cohort, a dynamic cohort study conducted during 26 months of the COVID-19 pandemic in the Netherlands.

Methods: Fixed-effects models were employed to estimate within-person associations between psychosocial factors and behaviour, combined with main and moderating effects of contextual factors.

Results: Pandemic severity was associated with more handwashing and distancing behaviour, while the duration of the pandemic had little effect. Within-person changes in response efficacy were most relevant for changes in both handwashing and distancing behaviour, while self-efficacy, descriptive norms and perceived severity of infecting others affected behaviour indirectly. These effects were stable over time. Associations were larger in cross-sectional models, indicating that such models tend to overestimate effects.

Conclusions: Our study highlights the importance of longitudinal data and within-person models to detect possible causal associations. The results suggest that during an outbreak, government and public health professionals should clearly communicate the severity of the pandemic (e.g., hospitalization rates) and the effectiveness of recommended prevention measures in reducing that risk; and seek to improve people's capabilities and opportunities to adhere to guidelines, for example, by modifying the environment.

Objective: Anticipated regret has been implicated in health-related decision-making. Recent work on influenza vaccination has suggested that anticipated relief, too, may influence individuals' decisions to engage in positive health behaviours. To explore these affective components further and address the generality of possible mechanisms underlying these associations, we examined whether anticipated relief and anticipated regret independently predict testicular self-examination (TSE) intention and behaviour. Given claims about differences in their nature and function, we distinguished between counterfactual relief (relief that a worse outcome did not obtain) and temporal relief (relief that an unpleasant experience is over).

Design: Prospective correlational.

Methods: At Time 1 (July 2022), 567 cis-gendered males were asked to complete measures of anticipated regret, anticipated counterfactual and temporal relief, measures of the Theory of Planned Behaviour and measures of anxiety and shame. One month later, the same participants were recontacted and asked about their engagement in TSE in the previous month.

Results: Anticipated counterfactual relief and anticipated regret are independent, positive, predictors of intention to engage in TSE and, indirectly, TSE behaviour itself. Interestingly, anticipated temporal relief was negatively associated with intention to engage in TSE and, indirectly, behaviour.

Conclusions: Our results suggest that it may be the counterfactual nature of anticipated regret and anticipated relief that underlies their positive association with TSE and other health-promoting behaviours. Interventions designed to increase engagement in preventive health behaviours, such as TSE, may benefit from the consideration of both positively and negatively valenced counterfactual emotions.

Background: Several authors have argued that vaccine hesitancy should be conceptualized as indecision in the vaccination decision-making process, but no established measure with support for its psychometric properties and validity has been created from this operational definition.

Aims: To resolve this tension, this article undergoes a four-study scale development process to create the 4-item Unidimensional Vaccine Hesitancy Scale (UVHS).

Materials and methods: We conduct four survey studies utilizing a total sample size of 884.

Results: In Studies 1 (n = 297) and 2 (n = 298), we provide psychometric support for the measure via exploratory and confirmatory factor analysis. In Studies 3 (n = 193) and 4 (n = 106), we support the concurrent and discriminant validity of the measure by assessing its relations with relevant constructs, such as vaccination readiness and acceptance, and we also provide initial indicators of the scale's possible predictive qualities by testing its time-separated effects with vaccination willingness, receipt and word-of-mouth.

Discussion: We leverage these results to provide a number of theoretical insights and suggestions for future practice. Of note, we highlight that different conceptualizations and operationalizations for the same construct can produce notably differing empirical findings, and vaccine hesitancy is no different.

Conclusion: Our cumulative efforts indicate that the UVHS is an appropriate measure to assess vaccine hesitancy as indecision.

Objectives: Behaviour change theories have extensively been used in health behaviour change interventions and their programme theories. However, they are rarely evaluated in randomized field studies. The Let's Move It intervention targeted various psychosocial constructs to increase adolescents' physical activity. A theory-based process evaluation aiming to illuminate the trial findings as well as to test the programme theory used is conducted. Specifically, we investigate whether the intervention influenced the theorized determinants of change immediately post-intervention and after 1 year, and whether these determinants were associated with changes in physical activity.

Design: A cluster-randomized controlled trial (n = 1166).

Methods: We measured theorized determinants with self-report, and physical activity (PA) with accelerometry and self-report. The effects are evaluated with repeated measures ANOVA and regression models.

Results: No changes were detected in most theorized determinants but intervention arm reported higher enactment of behaviour change techniques used during intervention immediately post-intervention and lower descriptive norms for PA throughout. Autonomous motivation was associated with PA immediately post-intervention.

Conclusions: The lack of intervention effects may be due to many factors, for example insensitive measures, ceiling effects. However, reporting these null effects advances understanding of behaviour change processes. We introduce methodologic possibilities for future intervention programme theory evaluation efforts.

Background: The present study aimed to understand the experiences of older adult participants and service deliverers involved in a UK-based physical activity programme, developed using participatory approaches.

Methods: Focus groups and one-to-one interviews were conducted with 34 older adults (aged 55+ years) and 13 service providers. Inductive thematic analysis was conducted, structured using the framework approach.

Findings: Four themes were identified: (1) Co-designed activities met needs and encouraged attendance; (2) engagement and access of programme activities; (3) enjoyment and perceived benefits of sessions; and (4) support needs of individuals delivering activities. Co-designed activities appeared to meet participant needs and instil a sense of ownership of the programme. Feeling able to relate to other participants seemed important and of potential relevance to attracting older adults to the programme. Peer support may help to increase confidence in attending sessions; place-based approaches (using resources in local communities) and a flexible approach to involvement also seemed to facilitate engagement. Enjoyment of the programme appeared to be enhanced through activity variety and opportunity for socializing, with a sense of community being created through the support and encouragement of fellow participants. It was considered important that volunteers had appropriate recognition and ongoing support.

Conclusions: These findings suggest that using participatory approaches may facilitate enjoyment and sustained engagement of older adults. Provision based on local community assets may contribute to sustainability of services. However, providing ongoing support is imperative, requiring further costs and resources over the longer-term.

Objectives: BRCA1/2 pathogenic variants have been associated with an increased risk for breast, ovarian, pancreatic, prostate cancer as well as melanoma. The present research uses the Leventhal's common-sense model of self-regulation (CSM), a theoretical framework highlighting the role of mental representations on responses to a health-threat. We aim at understanding the personal meaning and representation of living with an hereditary breast and ovarian cancer predisposition.

Method: Semi-structured interviews of 15 BRCA carriers were analysed using the interpretative phenomenological analysis.

Results: Mental representations develops in childhood and are influenced by childhood emotional responses to the familial experience of the BRCA predisposition. Pre-existing beliefs about BRCA, even erroneous, are deeply anchored and not called into question by medical informations given during the genetic counselling. This is particularly true when medical information is perceived as too complex, inconsistent or in contradiction with familial experience. These beliefs about the consequences of being carriers of the BRCA gene influence emotional and behavioural experiences leading to experience fear, anxiety, lack of hope for future or self-identity change. For participants with a traumatic familial experience of cancer, the lack of treatment for this genetic disease generates a perpetual overestimation of cancers' risk and the feeling of an unending danger associated with early death despite breast and ovarian prophylactic surgery. When strong negative representations of the BRCA predisposition are experienced, dysfunctional health behaviours, such as drugs consumption or overuse of medical consultations, could appear consecutively to emotional disorders.