Why is changing health-related behaviour so difficult?

Kelly, Michael P.; Barker, Mary

doi:10.1016/j.puhe.2016.03.030

Cited by 890 publications

(684 citation statements)

References 28 publications

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“…9 Greater adherence to preventative practices has also been reported among nonsmokers, which is appropriate as such individuals tend to be more health conscious than smokers. 21 In the current study, the median preventative practice score was 5, indicating that participants followed only approximately one-third of the preventative practices recommended by the ADA. 17 Critically, only 32.3% of the current sample reported regularly an unsatisfactory level of adherence to recommended guidelines among 5,000 subjects with DM visiting a tertiary hospital in South Korea; however, 84.9% of patients reported having undergone an HbA1c test in comparison to only 20% of participants in the current study.…”

Section: Discussionmentioning

confidence: 60%

Diabetes-Related Knowledge and Preventative Practices Among Government Employees with Diabetes in Kuwait

Abdulsalam

Aldaihani

Francis³

2018

Sultan Qaboos Univ Med J

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Objectives: Diabetes mellitus (DM)-related knowledge and preventative practices are vital for the successful management of this condition. In Kuwait, few studies have been conducted to evaluate the knowledge and preventative practices of DM patients. This study aimed to assess DM-related knowledge and preventative practices among government employees with DM in Kuwait and to examine associations between DM knowledge, preventative practices and other variables. Methods: This cross-sectional study was conducted in June 2015 and involved 345 employees with DM from 15 government ministries in Kuwait. A self-administered Arabic-language questionnaire was designed to assess DM-related knowledge and preventative practices based on the Diabetes Knowledge Test and the recommendations of the American Diabetes Association, respectively. Results: A total of 312 ministry employees agreed to participate in the study (response rate: 90.4%). The mean age was 45.6 ± 10.6 years. A total of 63.4% were male and 64.1% were Kuwaiti. The median DM knowledge score was 9 out of 14 and the median preventative practice score was 5 out of 14. High knowledge scores were significantly associated with education (β = 1.510; P ≤0.001) and income (β = 0.896; P ≤0.001). High preventative practice scores were significantly associated with income (β = 1.376; P = 0.002), DM duration (β = 0.919; P = 0.026) and knowledge scores (β = 1.783; P = 0.015). Conclusion: Government employees in Kuwait were found to have average DM knowledge and poor preventative practices. It is therefore imperative that policy-makers develop educational and health-promoting campaigns to target government employees with DM in Kuwait.

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Section: Discussionmentioning

confidence: 60%

Diabetes-Related Knowledge and Preventative Practices Among Government Employees with Diabetes in Kuwait

Abdulsalam

Aldaihani

Francis³

2018

Sultan Qaboos Univ Med J

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“…However, the positive outcomes obtained in CONTROL suggest that self‐monitoring, feedback, and whatever accountability and support can be obtained from a brief weigh‐in may be sufficient to produce clinically significant weight loss for motivated treatment‐seeking individuals and that more complex interventions such as GROUP and SMART may not always be necessary. CONTROL also included printed education materials regarding healthy diet and PA, but education alone typically does not result in meaningful behavior change . Thus, the printed materials are unlikely to have contributed much to the weight loss in CONTROL.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Smartphone‐Based Behavioral Obesity Treatment With Gold Standard Group Treatment and Control: A Randomized Trial

Thomas

Bond

Raynor

et al. 2019

Obesity

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Objective This study aimed to determine whether weight losses from a primarily smartphone‐based behavioral obesity treatment (SMART) differed from those of a more intensive group‐based behavioral obesity treatment (GROUP) and a control condition (CONTROL). Methods A total of 276 adults with overweight/obesity were randomly assigned to 18 months of GROUP‐based treatment with meetings weekly for 6 months, meetings biweekly for 6 months, and meetings monthly for 6 months and self‐monitoring via paper diaries with written feedback; SMART‐based treatment with online lessons, self‐monitoring, and feedback plus monthly weigh‐ins; or a CONTROL condition with self‐monitoring via paper diaries with written feedback and monthly weigh‐ins. Results Among the 276 participants (17% men; 7.2% minority; mean [SD] age: 55.1 [9.9] years; weight: 95.9 [17.0] kg; BMI: 35.2 [5.0] kg/m2), 18‐month retention was significantly higher in both GROUP (83%) and SMART (81%) compared with CONTROL (66%). Estimated mean (95% CI) weight change over 18 months did not differ across the three conditions: 5.9 kg (95% CI: 4.5‐7.4) in GROUP, 5.5 kg (95% CI: 3.9‐7.1) in SMART, and 6.4 kg (95% CI: 3.7‐9.2) in CONTROL. Conclusions Mobile online delivery of behavioral obesity treatment can achieve weight loss outcomes that are at least as good as those obtained via the more intensive gold standard group‐based approach.

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“…Behaviour change interventions are notoriously difficult to implement [78], even outside the context of sleep-deprived families coming to terms with the disruption of a new diagnosis in their infant child [79]. Furthermore, following a diagnosis of perinatal stroke, families experience a range of emotions including feelings of guilt and self-blame [74, 75].…”

Section: Discussionmentioning

confidence: 99%

Participatory design in the development of an early therapy intervention for perinatal stroke

et al. 2017

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BackgroundPerinatal stroke is the leading cause of unilateral (hemiparetic) cerebral palsy, with life-long personal, social and financial consequences. Translational research findings indicate that early therapy intervention has the potential for significant improvements in long-term outcome in terms of motor function. By involving families and health professionals in the development and design stage, we aimed to produce a therapy intervention which they would engage with.MethodsNine parents of children with hemiparesis and fourteen health professionals involved in the care of infants with perinatal stroke took part in peer review and focus groups to discuss evolving therapy materials, with revisions made iteratively. The materials and approach were also discussed at a meeting of the London Child Stroke Research Reference Group. Focus group data were coded using Normalisation Process Theory constructs to explore potential barriers and facilitators to routine uptake of the intervention.ResultsWe developed the Early Therapy in Perinatal Stroke (eTIPS) program - a parent-delivered, home-based complex intervention addressing a current gap in practice for infants in the first 6 months of life after unilateral perinatal stroke and with the aim of improving motor outcome. Parents and health professionals saw the intervention as different from usual practice, and valuable (high coherence). They were keen to engage (high cognitive participation). They considered the tasks for parents to be achievable (high collective action). They demonstrated trust in the approach and felt that parents would undertake the recommended activities (high collective action). They saw the approach as flexible and adaptable (high reflexive monitoring). Following suggestions made, we added a section on involving the extended family, and obtained funding for a website and videos to supplement written materials.ConclusionsFocus groups with parents and health professionals provided meaningful feedback to iteratively improve the intervention materials prior to embarking on a pilot study. The intervention has a high potential to normalize and become a routine part of parents’ interactions with their child following unilateral perinatal stroke.

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Why is changing health-related behaviour so difficult?

Abstract: It is important to understand the conditions preceding behaviour psychologically and sociologically and to combine psychological ideas about the automatic and reflective systems with sociological ideas about social practice.

Cited by 890 publications

References 28 publications

Diabetes-Related Knowledge and Preventative Practices Among Government Employees with Diabetes in Kuwait

Diabetes-Related Knowledge and Preventative Practices Among Government Employees with Diabetes in Kuwait

Comparison of Smartphone‐Based Behavioral Obesity Treatment With Gold Standard Group Treatment and Control: A Randomized Trial

Participatory design in the development of an early therapy intervention for perinatal stroke

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