Knowledge, attitudes, behavioral and organizational factors of health professions students for a competent smoking cessation practice: An instrument adaptation and psychometric validation study in Spanish and English samples.

BACKGROUND: To improve smoking cessation, training of health professions students is essential. However, no specific instrument is available to assess factors that may affect students' learning about smoking cessation practice. AIM: To adapt and validate the Knowledge, Attitudes, Behaviors and Organization questionnaire in the population of undergraduate health professions students. DESIGN: Methodological research. METHODS: The researchers conducted this study with 511 Spanish and 186 English health professions students from four different universities. We used a four-step approach: 1) adaptation of the items to the target population and validation of the content by a panel of experts; 2) a pilot study to test face validity; 3) linguistic adaptation of the Spanish version to English; and 4) the psychometric assessment based on construct validity, criterion validity and internal consistency. RESULTS: Exploratory factor analysis revealed four subscales for the Spanish version, namely 'Individual knowledge and skills', 'Individual attitudes and beliefs', 'Organizational support' and 'Organizational resources', which accounted for 85.1% of the variance. Confirmatory factor analysis in the holdout Spanish and English samples revealed adequate goodness-of-fit values, supporting the factor structure. Hypotheses testing demonstrated significant differences by capacitation in smoking cessation interventions and degree courses, providing further evidence regarding construct validity. All the subscales correlated positively with the criterion variables (5 A's smoking cessation model), except for the 'Organizational resources' subscale, which was not significantly correlated with the 5 A's. The overall Cronbach's alpha was.83 for the Spanish version and.88 for the English one. CONCLUSIONS: Our results provide empirical support for the use of the Knowledge, Attitudes, Behaviors and Organization questionnaire for Students as a reliable and valid instrument to assess knowledge, attitudes, behaviors and organization perceptions in health professions students, which is essential for competent smoking cessation practice. Interestingly, 'Organizational resources' subscale presented the lowest correlations among factors and did not correlate with any component of the 5 A's, suggesting the need of enhancing students' responsibility and involvement during their internships, as well as the interest of some organizations.

Adherence to healthy diet and physical activity in clinical patients / Adherencia a la dieta saludable y a la realización de actividad física en pacientes

BACKGROUND: The aim of this study is to explore the psychometric properties of the Motiva.Diaf questionnaire, which assesses the adherence to healthy diet and physical activity in clinical patients. METHOD: Participants were 230 patients, who attended hospital services, with a mean age of 49.28 years (SD = 12.34). Women constituted 55.7% of the patients. Two weeks after initial administration, 40 participants, from those who had another hospital appointment scheduled, were selected at random to complete again the questionnaire in order to assess test-retest reliability. RESULTS: the accuracy of the scores is adequate both in terms of internal consistency (α = .802; Ω = .776) and temporal stability (r =.786). The test's structure is essentially one-dimensional, and the scores in this dimension converge with other necessary basic psychological measurements (r Diet = .294; r Physical Activity= .359) and perceived health (r = .266). In addition, a relatively moderate relationship was found with the Body Mass Index (r = - .129). CONCLUSIONS: The test has shown adequate reliability and validity for evaluating adherence to healthy habits. The availability of an instrument with these characteristics has significant implications for evaluating behaviour, designing and implementing behavioural interventions

ANTECEDENTES: el objetivo de este estudio ha sido explorar las propiedades psicométricas del cuestionario Motiva.Diaf, diseñado para medir la adherencia a las características de la dieta saludable y realización de actividad física en personas enfermas. MÉTODO: participaron 230 pacientes, que asistieron a consultas hospitalarias, con una edad media de 49,28 años (SD = 12,34), siendo un 55,7 % mujeres. Dos semanas tras la administración inicial, se seleccionaron al azar 40 participantes, de los que tenían otra cita hospitalaria, para completar nuevamente el cuestionario con el fin de evaluar la fiabilidad test-retest. RESULTADOS: la precisión de las puntuaciones es adecuada en términos de consistencia interna (α = .802; Ω = .776) y de estabilidad temporal (r =.786). La estructura del test es esencialmente unidimensional y las puntuaciones en esta dimensión convergen con las medidas de necesidades psicológicas básicas (r Diet = .294; r Physical Activity= .359) y salud percibida (r = .266). También se encontró una relación moderada con IMC (r = - .129). CONCLUSIONES: Motiva.Diaf ha demostrado una fiabilidad y validez. La disponibilidad de un instrumento de estas características tiene implicaciones significativas en la evaluación de las conductas, diseño e implementación de intervenciones conductuales

Health promotion and lifestyle advice in a general practice: what do patients think?

BACKGROUND/RATIONALE: Since 1990 health promotion and lifestyle advice has been integrated in general practice and has been mainly undertaken by practice nurses. However little is known about patients' views of the service provided. AIMS OF THE STUDY: To examine patients' recall and perceptions of lifestyle counselling received from practice nurses in a general practice in the North-east of England. To investigate the extent to which patients' needs are met. To assess the main sources of health information sought by patients. DESIGN/METHODS: Cross-sectional descriptive survey. A total of 512 patients were sent a postal questionnaire about current lifestyle, recall of lifestyle advice received and perceptions of the advice provided. FINDINGS: A response rate of 64% was achieved. Questionnaire analysis revealed unhealthy lifestyles among the population studied that could be addressed through health promotion, e.g. 25% were smokers; 44% exercised occasionally; 40% had a body mass index >25 kg/m2. Advice received on diet was reported by 6% of patients; on exercise by 4%; on smoking by 4% and on alcohol consumption by 2%. Patients were willing to receive more health promotion in areas such as stress, exercise and weight reduction. Magazines (67%) and TV (47%) were selected as the main sources for health promotion information. CONCLUSIONS: Health needs to be promoted. The low rate of lifestyle advice reported by the patients implies that more preventive advice should be provided in primary care settings. More effective health promotion should be planned according to the needs of the practice population.